Methods: Between September 2020 and May 2022, a total of 94 patients (60 males, 34 females; mean age 59.5±12.2 years; range, 32 to 84 years) who underwent surgery for lung cancer were prospectively analyzed. The patients were evaluated using the BPI preoperatively and on postoperative Days 0, 3, and 30. The preoperative emotional impacts of patient variables and the influence of surgical management on postoperative pain were examined.

Results: Females experienced more preoperative emotional distress and insomnia (p=0.046, p=0.033, respectively). Patients diagnosed with cancer and had a history of surgery or thoracotomy demonstrated higher preoperative emotional distress (p=0.001, p<0.001, p<0.001, respectively). Postoperatively, patients who underwent thoracotomy reported greater pain with higher functional impairment compared to the video-assisted thoracoscopic surgery group (p=0.002, p=0.018, respectively). Patients whose drains were completely removed by the postoperative Day 3 had reduced discomfort and improved ability to perform breathing exercise (p=0.005, p=0.045, respectively). Thoracotomy and the placement of double drains were identified as independent factors contributing to difficulties in performing breathing exercises and coughing on Day 30 (p<0.05 for all). There was no significant difference in the pain scores and affected functions between the patients with a thoracotomy incision size of <10 cm and ?10 cm (p=0.200, p=0.113, respectively).

Conclusion: Our study results indicate that a preference for minimal invasive procedures, the use of a single thoracic drain, and the prompt removal of the drain minimize pain and functional impairment. Women, patients with a preoperative diagnosis of malignancy requiring metastasectomy, and history of thoracotomy or surgery experience elevated l evels o f a nxiety. T herefore, c onsistent m onitoring a nd psychological support may be recommended to improve the quality of life for this patient population.