Factors related to post‐thoracotomy pain following robotic‐assisted thoracic surgery

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Background Robotic‐assisted thoracic surgery (RATS) is a minimally invasive procedure; however, some patients experience persistent postoperative pain. This study aimed to investigate factors related to postoperative pain following RATS. Methods The data of 145 patients with lung cancer, who underwent RATS with a four‐port (one in the sixth intercostal space [ICS] and three in the eighth ICS) lobectomy or segmentectomy between May 2019 and December 2022, were retrospectively analyzed. Factors associated with analgesic use for at least 2 months following postoperative pain (PTP group) were analyzed. Results Patients who underwent preoperative pain control for any condition or chest wall resection were excluded. Among the 138 patients, 45 (32.6%) received analgesics for at least 2 months after surgery. Patient height and transverse length of the thorax correlated with PTP in the univariate analysis (non‐PTP vs. PTP; height, 166 vs. 160 cm; p < .001; transverse length of the thorax, 270 vs. 260 mm, p = .016). In the multivariate analysis, height was correlated with PTP ( p = .009; odds ratio, 0.907; 95% confidence interval, 0.843–0.976). Height correlated with the transverse length of the thorax ( r = .407), anteroposterior length of the thorax ( r = .294), and width of the eighth ICS in the middle axillary line ( r = .210) using Pearson's correlation coefficients. When utilizing a 165‐cm cutoff value for height to predict PTP using receiver operating characteristic curve analysis, the area under the curve was 0.69 (95% confidence interval, 0.601–0.779). Conclusion Short stature is associated with a high risk of postoperative pain following RATS.