A Technique Facilitating Muscle-Sparing Thoracotomy

Akçalı, Yiğit; Demır, Hasan; Tezcan, Bekir

doi:10.1177/021849230201000229

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…All authors in this group [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] noted occasional need to divide lower attachments of serratus anterior muscle to obtain adequate exposure (broken line on Figure 5). Among these 17 references there are six randomized controlled trials of Type III vs. posterolateral thoracotomy.…”

Section: Disadvantagesmentioning

confidence: 99%

Muscle-Sparing Thoracotomy: A Systematic Literature Review and the “AVE” Classification

Scanagatta¹

2015

J Surg Surgical Res

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Background: To synthesize the concept of muscle-sparing thoracotomies for major pulmonary resections and to explore the relationship between Kraissl's lines and skin incisions perpendicular to them. Methods: Systematic literature review was performed of MEDLINE database. Articles were selected if they described adult patients undergoing major pulmonary resection by way of a welldescribed thoracotomy that neither partially nor completely transects outer thoracic muscles, and that is independent of endoscopic instruments, and video technology. Median sternotomy was excluded. Results and Discussion: On the basis of analysis of 45 articles we propose an anatomical classification of muscle-sparing thoracotomies considering the way in which the muscles are spared. Classification distinguishes five types of muscle-sparing thoracotomies which are represented originally using cylindrical projection of thorax. Type I is realized by enlarging auscultatory triangle, Type II by splitting of latissimus dorsi muscle fibers beneath the bifurcation of thoracodorsal nerve and artery, Type III by retracting latissimus muscle posteriorly and serratus anterior muscle anteriorly, Type IV by separating digitations of serratus anterior muscle in front of the long thoracic nerve, and Type V by disinserting serratus anterior muscle in its medial part. The significance of Kraissl's lines remains unknown. Conclusions: Proposed classification is original and might have a didactic role. It facilitates evidence-based approach to comparative studies. Thoracic maps are a useful way to express this concept. Thoracic maps and human body throughout this text should be placed in the same context as planet earth and world map. They are intended to act as carriers of the results of systematic literature review. Regarding Figure 1 it is essential to notice that the thoracic wall is divided conventionally by anterior and posterior axillary folds in anterior, lateral, and posterior walls. Furthermore, the lower margin Each projection is an attempt to fit a curved surface onto a flat

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Section: Disadvantagesmentioning

confidence: 99%

Muscle-Sparing Thoracotomy: A Systematic Literature Review and the “AVE” Classification

Scanagatta¹

2015

J Surg Surgical Res

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“…1,10,13,14,17 Most studies concur that there is no difference in operating time between the 2 techniques; opening time is longer in MST but the closing time is shorter compared with the PLT approach, so the overall operating time is equal with either of the techniques. 1,10,17,18 In an attempt to clarify this controversy, several metaanalyses have been performed. A meta-analysis by Uzzaman et al of 12 different studies comparing MST (n = 571) and PLT (n = 512) revealed better shoulder internal rotation in the muscle-sparing group (although there were no differences in shoulder abduction, flexion, or external rotation), decreased postoperative pain on day 7 (but not on days one or 30), and no difference in lung function at 30 days after operation.…”

Section: Introductionmentioning

confidence: 99%

Muscle-sparing Thoracotomy

Elswick

Blackmon

Sharaf

2017

Operative Techniques in Thoracic and Cardiovascular Surgery

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Surgical access to the thoracic cavity can be performed through a variety of approaches. Traditional surgical approaches focused on optimizing exposure, often times at the expense of sparing adjacent truncal muscles, such as the latissimus dorsi or serratus anterior, which can serve as lifeboats in thoracic reconstruction. Numerous studies have evaluated the differences in these techniques, focusing on surgical access, postoperative pain, shoulder strength and mobility, and lung function. We advocate, whenever possible, the routine use of a muscle-sparing thoracotomy to preserve vital local flap options for reconstruction of postresection complications. These flaps can assist in the management of postoperative wound healing complications, such as empyemas and bronchopleural fistulae. When local flap options are unavailable, other flap options are often more morbid and can be challenging. Herein, we describe the technique for a musclesparing thoracotomy at our institution.

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Clinical application of thoracic small incision in radical operation for lung and esophageal cancer

Wang

Han

et al. 2009

Chin. -Ger. J. Clin. Oncol.

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Traditional posterior lateral incision is still used most frequently in thoracotomy in Department of Thoracic Surgery till now, which has advantages of clear operation field, and easy to operate etc., however, it also has disadvantages of severe incision pain, and disorder of affected upper limb after operation etc. Along with the development of surgical technology, there have been data indicated that as an operation method, video-assisted thoracoscopic surgery (VATS) is feasible, however, application time of VATS is short, operation number of it is few, cost of it is expensive, and operation effects and application value of it need to be observed further, and good operation effects in short-term obtained need to be followed and to be summed up. Therefore, VATS can not replace conventional thoracotomy and be used extensively in Department of Thoracic Surgery. We designed a shorter muscle spare incision to reduce thoracic trauma, and performed 143 radical operations for lung and esophageal cancer, and explored a operation method which is of same effects of conventional incision, relatively minor trauma, and can be used extensively. Materials and methods General informationCollect data of patients, who had complete medical record and were given radical operation for lung and esophageal cancer, in our department from

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A Technique Facilitating Muscle-Sparing Thoracotomy

Cited by 3 publications

References 4 publications

Muscle-Sparing Thoracotomy: A Systematic Literature Review and the “AVE” Classification

Muscle-Sparing Thoracotomy: A Systematic Literature Review and the “AVE” Classification

Muscle-sparing Thoracotomy

Clinical application of thoracic small incision in radical operation for lung and esophageal cancer

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