Postoperative Patient-Reported Outcomes after Uniportal Video-Assisted Thoracoscopic Surgery Using the Perioperative Symptom Assessment for Lung Surgery Scale

Round 1

Reviewer 1 Report

Lung function is a well-established factor before lung surgery. This study assessed the importance of perioperative symptom assessment for lung surgery. The details and methodology are sound; however, I fail to see the novelty in the paper. It would be beneficial to point out how PSA would affect our clinical practice.

Preoperative exercise training for low FEV1 patients is already well-established, please point out how perioperative symptom assessment can help in clinical practice.

Another very interesting finding is regarding coughing. Is there a recommendation that can be drawn from data? Is there a subset of patients where coughing can be expected and maybe medication can be given with preventive intent?

 

 

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

After perusing the entire article, I feel it was well written with acceptable language and good layout. However, your results and conclusion did not have any effective contribution to the future treatment of patients after thoracic surgery. I cannot understand why you choose uniportal surgery and not conventional VATS  or just open thoracotomy. You have to explain. You stated that VATS is the mainstay treatment for lung surgery. To the best of my knowledge, it is correct only in China or some countries in Asia. In Europe and America and even some parts in Japan. almost half of the thoracic surgeries are still being performed through traditonal open thoracotomy. The following are some other of my comments.

(1) Were those patients in your study operated by the same surgeon ?

(2) As you stated cough was an significant symptom and affected patients' lives. But you didn't look into and mention the postoperative causes of cough. Were their causes the same ?  Post-lung surgery cough usually related with many factors, anesthesia (intubation etc.); surgical factors (injuries of vagal branches, endobronchial sutures etc. ); chemical factors ( bradykinin, prostaglandin etc). This will help you to improve the outcome.

(3) In your 'Discussion', you did not state your remedies and the possible preventive measures

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Thank you for your detailed answers and revision. Also you have good explanations and defense. However, those factors you found out are almost can't be corrected clinically. That is why I stated in my previous review that your conclusion won't offer any contribution to the future surgery.