Is Muscle-Sparing Thoracotomy Advantageous

Abstract

Background: The aim of this study was to compare muscle-sparing thoracotomy for the latissimus dorsi and the serratus anterior muscles (MST-L), and muscle-sparing thoracotomy for serratus anterior muscle (MST-S) with each other and with standard posterolateral thoracotomy (SPLT) in terms of advantages and disadvantages. Methods: Sixty patients (18 females, 42 males; mean age 42.6 +/- 16.6 years; range 15 to 72 years) in whom thoracotomy was indicated were randomly grouped into three categories. The groups were compared in terms of the effects of thoracotomy on shoulder range of motion, muscle strength, pulmonary function, postoperative pain, and duration of hospitalization. Results: Shoulder range of motion and serratus anterior muscle strength in the SPLT group were significantly lower than in the other groups. The latissimus dorsi muscle strength in the MST-L group was significantly better than that of the other groups. The parameters of pulmonary function on days 3 and 7 in the MST-L group were significantly better than those of the other groups. The duration of hospitalization in the MST-L group was significantly shorter than that of the other groups. Conclusion: The improvement of pulmonary function occurs earlier in thoracotomies that spare the chest wall muscles, and postoperative complications due to detachment are decreased. Although there is a better field of view in SPILT and MST-S than that of MST-L, considering the other advantages of MST-L, we recommend initiating with MST-L in all thoracotomies, except in emergency cases.