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Editorials |

Painful Lessons From the Other Side (of the Diaphragm)

Maroun M. Tawk, MD, FCCP; Gary Kinasewitz, MD, FCCP
Author and Funding Information

Affiliations: Oklahoma City, OK
 ,  Dr. Tawk is Assistant Professor of Medicine, and Dr. Kinasewitz is Professor of Medicine and Chief Pulmonary and Critical Care Medicine, University of Oklahoma Health Sciences Center.

Correspondence to: Gary T. Kinasewitz, MD, FCCP, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP, Oklahoma City, OK 73104; e-mail: priscilla-peer@ouhsc.edu



Chest. 2006;130(3):635-636. doi:10.1378/chest.130.3.635
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Postthoracotomy pain is relatively easy to understand given the trauma to the chest wall and ribcage that occurs during surgery.1 Approximately one half of the patients who undergo thoracotomy will continue to have chronic pain unrelated to recurrent disease 1 year after surgery.23 Video-assisted thoracic surgery is less invasive but is still associated with significant long-term morbidity.4 Even simple pleural sclerosis by abrasion or talc poudrage for benign disease such as spontaneous pneumothorax results in chronic pain in 10 to 30% of patients 1 year after video-assisted thoracic surgery.57 While it is tempting to blame injury to the intercostal nerve or adjacent rib for the chronic pain, the answer may lie within the thoracic cavity.

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