However , intercostal nerve injury seems to be the most important pathogenic factor .
Chronic pain complaints after thoracic surgery represent a significant clinical problem in 25 - 60 % of patients .
Results from thoracic and other surgical procedures suggest multiple pathogenic mechanisms that include pre- , intra- , and postoperative factors .
This review attempts to analyse the methodology and systematic s of the studies on the  post-thoracotomy pain syndrome ( PTPS ) after lung cancer surgery in adults , in order to clarify the relative role of possible pathogenic factors and to define future strategies for prevention .
The effects of cryoanalgesia combined with thoracic epidural analgesia in patients undergoing thoracotomy
This study was performed to evaluate the effects of cryoanalgesia combined with thoracic epidural analgesia on pain and respiratory complications in patients undergoing thoracotomy . Ninety patients were prospect ively r and omised to epidural analgesia alone ( n = 45 ) or epidural analgesia and cryoanalgesia combined ( n = 45 ) . We monitored the use of rescue pain medication and changes in forced vital capacity and forced expired volume in 1 s , and recorded pain and opioid‐related side‐effects during the immediate postoperative period . The incidence of post‐thoracotomy pain and numbness were also assessed up to the sixth month after surgery . Cryoanalgesia combined with thoracic epidural analgesia was associated with earlier recovery in pulmonary function , less pain during movement and a lower daily requirement for rescue analgesia one week after surgery . However , the combination of cryoanalgesia and epidural analgesia failed to decrease the incidence of long‐term pain and numbness . In view of its associated long‐term morbidity , cryoanalgesia combined with thoracic epidural analgesia is not recommended for patients undergoing thoracotomy
However , intercostal nerve injury seems to be the most important pathogenic factor .
Chronic pain complaints after thoracic surgery represent a significant clinical problem in 25 - 60 % of patients .
Results from thoracic and other surgical procedures suggest multiple pathogenic mechanisms that include pre- , intra- , and postoperative factors .
This review attempts to analyse the methodology and systematic s of the studies on the  post-thoracotomy pain syndrome ( PTPS ) after lung cancer surgery in adults , in order to clarify the relative role of possible pathogenic factors and to define future strategies for prevention .