Suture techniques of the intercostal space in thoracotomy and their relationship with post-thoracotomy pain: a systematic review.

Post-thoracotomy pain is a symptom of high incidence among patients who have undergone thoracotomy and is a major risk factor in the pathogenesis of several postoperative complications. Chronic pain after thoracotomy reaches a high prevalence. Since the earliest studies, this pain has been seen to be related with intercostal nerve injury, thus the need to avoid these lesions during thoracotomy has been recommended. This review aims to establish the appropriate surgical procedure for closure of the thoracotomy through a systematic review of the literature and analysis of levels of evidence provided by the studies found. After an exhaustive search in MEDLINE, EMBASE, IME, IBECS and Cochrane Library, few studies were found. Each focuses on different aspects of thoracotomy surgical techniques, with a common denominator focused on the preservation of the intercostal nerves, and conclusions with different levels of evidence.