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 role of video-assisted thoracic surgery for the treatment of lung cancer: lung lobectomy by thoracoscopy versus the standard thoracotomy approach.
Our objective was to evaluate the usefulness , safety , validity and benefits of video-assisted thoracoscopic surgery ( VATS ) for performing pulmonary lobectomy in 24 patients with clinical NO stage I primary non-small-cell lung cancer compared with 30 patients who underwent a conventional thoracotomy .  There were no significant differences in the intra-operative blood loss , duration of operation , or duration of chest tube drainage between the VATS group and the st and ard lobectomy group , but in this VATS ' experience , patients had less postoperative pain . Numbers and distributions of dissected lymph-nodes were similar in patients whether undergoing st and ard thoracotomy or VATS lobectomy . We can confirm that the safety and validity of VATS are virtually identical to those of the st and ard thoracotomy approach in the lobectomy . However , the former technique causes less discomfort to patients and requires a shorter recovery period of laboratory data and IL-6 concentrations in thoracic drainage fluid . We conclude that VATS major lung resection is technically feasible . Stringent patient selection is important and special training is needed
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 .