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 .
A study exploring the role of intercostal nerve damage in chronic pain after thoracic surgery.
OBJECTIVE Our aim was to investigate the prevalence of intra-operative nerve damage and its association with  chronic pain .  METHODS Our prospect i ve study of 33 patients used nerve conduction studies to assess intercostal nerve function during elective thoracic surgical procedures . We used two methods to study nerve conduction : pre-operative magnetic stimulation ( in 10 patients ) and intra-operative nerve conduction studies ( in all patients ) We correlated these findings with specific intra-operative parameters , pain and psychological question naires pre-op and 3 month post-op and altered cutaneous sensation . RESULTS Magstim ( magnetic stimulation ) assessment s were not reliable and were therefore ab and oned . Intraoperative intercostal nerve studies revealed two distinct patterns of nerve injury and also that nerve injury was less in those cases where a rib was not resected . However , intercostal nerve damage detected at the time of operation is not associated with chronic pain or altered cutaneous sensation at 3 months post-op . CONCLUSIONS The study findings suggest that either the amount of intra-operative intercostal nerve damage is not indicative of long-term nerve damage or that there is a more significant cause for chronic pain other than intercostal nerve injury
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 .