Posterolateral thoracotomy, muscle sparing posterolateral thoracotomy, anterior thoracotomy in primary lung cancer: comperison of pre-postoperative results

Serhan Tanju, Sedat Ziyade, Erkan Kaba, Murat Sarıçam, Alper Toker, Sukru

DilegeIstanbul University Istanbul Faculty of

Medicine Department of Thoracic Surgery

Aim Resection in primary lung cancer

Posterolateral thoracotomy Posterolateral muscle sparing

thoracotomy Anterior thoracotomy

Material and Method January 2003-December 2004 Randomized, 75 patient Group 1 (n=25):Posterolateral

thoracotomy Group 2 (n=25):Posterolateral

muscle sparing thoracotomy Group 3 (n=25):Anterior thoracotomy

Group 1Posterolateral thoracotomy

Lateral decubitus

Trapezius-latissimus dorsi, rhomboid- serratus anterior

Group 2muscle sparing posterolateral thoracotomy

Lateral decubitus Subcuteneus flep Between

Latissimus dorsi trapezius m.

Latissimus dorsi-toracolumbar fasia

Group 3Anterior thoracotomy

450 lateral decubitus

Muscle sparing Latissimus dorsi-serratus anterior

Intrathoracic paravertebral plane

Material Method Age Gender, Lenght of insicion, Duration of Thoracotomy, Resection type, Duration pf hospital stay, VAS, Location and stage of tumor

Mann Whitney U Test

Eclusion criterias T3-chest wall T4-Central tumor Fractured rib pneumonectomy

Results

Group I n:25

Group II n:25 p

Mean Mean Age 60.48±7.72 55.40±8.42 >0.05 Lenght of incision / diameter of chest 0.3019±0.035

0.328±0.036 0.015

Duration of thoracotomy 48.48±7.92 47.92±6.25 0.705 Duration of hospital stay 8.08±1.77 7.36±1.70 0.105

VAS 5.56±1.38 5.04±1.39 0.216

Results

Group I n:25

Group III n:25 p

Mean Mean Age 60.48±7.72 59.04±9.49 >0.05 Lenght of incision / diameter of chest 0.3019±0.035

0.103±0.010 0.000

Duration of thoracotomy 48.48±7.92 33.08±2.37 0.000 Duration of hospital stay 8.08±1.77 6.64±2.92 0.007

VAS 5.56±1.38 3.16±0.68 0.000

Results

Group II n:25

Group III n:25 p

Mean Mean Age 55.40±10.14 59.04±9.49 >0.05 Lenght of incision / diameter of chest 0.328±0.036

0.103±0.010 0.000

Duration of thoracotomy 47.92±6.25 33.08±2.37 0.000 Duration of hospital stay 7.36±1.70 6.64±2.92 0.034

VAS 5.04±1.39 3.16±0.68 0.000

Results (location of the tumor)

Grup I

Grup II

Grup III

n n n RUL 7 7 8 RLL 5 4 2 RML 2 2 2 RUBL

RLBL 2 1 3 LUL 10 8 9 LLL 2 3 1

Results (stage of the tumor) Group 1

Stage I:15 Stage II: 5 Stage III: 4

Grup 2 Stage I:16 Stage II: 6 Stage III: 3

Grup 3 Stage I:18 Stage II: 3 Stage III: 4

Conclusion Anterior thoracotomy vs

posterolateral thoracotomy VAS Duration of thoracotomy Duration of hospital stay Lenght of incision

Conclusion anterior thoracotomy

Wound infection/seroma

Low pain;respiratuar exercise

BPF/ muscle transposition

Postop late period muscle strenght

Rib fractured

Expojour - Head-

light Asistant Major hemoraghe Plorodezis Endo-

enstrümantation