Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder Pain
ABSTRACT Background Ipsilateral shoulder pain (ISP) is a common complication following video‐assisted thoracoscopic surgery (VATS), significantly affecting postoperative recovery and quality of life. This study aimed to evaluate the relationship between intraoperative upper limb positioning, and the...
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Wiley
2025-01-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.15528 |
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| author | Yan Zhao Yang Gu Bin Hu |
| author_facet | Yan Zhao Yang Gu Bin Hu |
| author_sort | Yan Zhao |
| collection | DOAJ |
| description | ABSTRACT Background Ipsilateral shoulder pain (ISP) is a common complication following video‐assisted thoracoscopic surgery (VATS), significantly affecting postoperative recovery and quality of life. This study aimed to evaluate the relationship between intraoperative upper limb positioning, and the occurrence of ISP, with the goal of optimizing positioning to reduce postoperative complications. Methods This prospective cohort study included 252 patients undergoing VATS for lung resection. The A angle (shoulder flexion) and B angle (shoulder abduction) were measured intraoperatively. ISP was assessed using the Visual Analog Scale (VAS) on the first postoperative day and 1 week after surgery. Univariate and multivariate logistic regression analyses were performed to identify predictors of ISP, and receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic accuracy of shoulder positioning in predicting ISP. Results The incidence of ISP was 26.2% (66/252). Multivariate analysis revealed that larger A angles (OR: 1.061, 95% CI: 1.009–1.115, p = 0.021) were associated with a higher risk of ISP, while larger B angles (OR: 0.798, 95% CI: 0.744–0.856, p < 0.001) were protective against ISP. ROC curve analysis demonstrated a strong predictive value for the combined influence of A and B angles, with an area under the curve (AUC) of 0.822. Conclusion Intraoperative upper limb positioning, specifically decreasing the A angle (shoulder flexion) and increasing the B angle (shoulder abduction), plays a critical role in reducing the incidence of ISP following VATS. These findings suggest that adopting an optimal shoulder posture during surgery can improve patient outcomes. |
| format | Article |
| id | doaj-art-f49b621ec16647898a773763380168f8 |
| institution | Kabale University |
| issn | 1759-7706 1759-7714 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj-art-f49b621ec16647898a773763380168f82025-01-30T22:40:34ZengWileyThoracic Cancer1759-77061759-77142025-01-01162n/an/a10.1111/1759-7714.15528Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder PainYan Zhao0Yang Gu1Bin Hu2Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaABSTRACT Background Ipsilateral shoulder pain (ISP) is a common complication following video‐assisted thoracoscopic surgery (VATS), significantly affecting postoperative recovery and quality of life. This study aimed to evaluate the relationship between intraoperative upper limb positioning, and the occurrence of ISP, with the goal of optimizing positioning to reduce postoperative complications. Methods This prospective cohort study included 252 patients undergoing VATS for lung resection. The A angle (shoulder flexion) and B angle (shoulder abduction) were measured intraoperatively. ISP was assessed using the Visual Analog Scale (VAS) on the first postoperative day and 1 week after surgery. Univariate and multivariate logistic regression analyses were performed to identify predictors of ISP, and receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic accuracy of shoulder positioning in predicting ISP. Results The incidence of ISP was 26.2% (66/252). Multivariate analysis revealed that larger A angles (OR: 1.061, 95% CI: 1.009–1.115, p = 0.021) were associated with a higher risk of ISP, while larger B angles (OR: 0.798, 95% CI: 0.744–0.856, p < 0.001) were protective against ISP. ROC curve analysis demonstrated a strong predictive value for the combined influence of A and B angles, with an area under the curve (AUC) of 0.822. Conclusion Intraoperative upper limb positioning, specifically decreasing the A angle (shoulder flexion) and increasing the B angle (shoulder abduction), plays a critical role in reducing the incidence of ISP following VATS. These findings suggest that adopting an optimal shoulder posture during surgery can improve patient outcomes.https://doi.org/10.1111/1759-7714.15528intraoperative positioningipsilateral shoulder painpostoperative complicationshoulder anglesVATS |
| spellingShingle | Yan Zhao Yang Gu Bin Hu Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder Pain Thoracic Cancer intraoperative positioning ipsilateral shoulder pain postoperative complication shoulder angles VATS |
| title | Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder Pain |
| title_full | Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder Pain |
| title_fullStr | Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder Pain |
| title_full_unstemmed | Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder Pain |
| title_short | Optimizing Shoulder Joint Positioning During Video‐Assisted Thoracoscopic Surgery: A Prospective Study on Prevention of Postoperative Ipsilateral Shoulder Pain |
| title_sort | optimizing shoulder joint positioning during video assisted thoracoscopic surgery a prospective study on prevention of postoperative ipsilateral shoulder pain |
| topic | intraoperative positioning ipsilateral shoulder pain postoperative complication shoulder angles VATS |
| url | https://doi.org/10.1111/1759-7714.15528 |
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