Muscle-sparing Axillary Thoracotomy

Irons, Mallory L.; Kucharczuk, John C.

doi:10.1053/j.optechstcvs.2018.02.004

Cited by 3 publications

(2 citation statements)

References 2 publications

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“…Lateral muscle-sparing open thoracotomy was performed in the fifth space using the Noirclerc technique [ 20 , 21 ]. A muscle-sparing axillary thoracotomy was performed in some patients in order to obtain a better cosmetic result [ 22 ]. The section of the intercostal nerves was performed on the superior margin of the inferior rib in order to preserve the intercostal vascular-nervous bundle.…”

Section: Methodsmentioning

confidence: 99%

Intraoperative Lung Ultrasound (ILU) for the Assessment of Pulmonary Nodules

et al. 2021

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Background: The primary aim of this study was to confirm the validity of intraoperative lung ultrasound (ILU) as a safe and effective method of localization for difficult to visualize pulmonary nodules during Video-Assisted Thoracoscopic Surgery (VATS) and open thoracotomy. The secondary aim was to enhance knowledge on the morphological patterns of presentation of pulmonary nodules on direct ultrasound examination. Materials and methods: 131 patients with lung nodule and indication for surgery were enrolled. All patients underwent pre-operative imaging of the chest, including Chest Computed Tomography (CT) and Transthoracic Ultrasound (TUS), and surgical procedures for histological assessment of pulmonary nodules (VATS or open thoracotomy). Results: The identification of 100.00% of lung nodules was allowed by ILU, while the detection rate of digital palpation was 94.66%. It was not possible to associate any specific ILU echostructural pattern to both benign or malignant lesions. However, the actual histological margins of the lesions in the operating samples were corresponding to those visualized at ILU in 125/131 (95.42%) cases. No complications have been reported with ILU employment. Conclusions: In our experience, ILU performed during both open surgery and VATS demonstrated to be a reliable and safe method for visualization and localization of pulmonary nodules non previously assessed on digital palpation. In addition, ILU showed to allow a clear nodule’s margins’ definition matching, in most cases, with the actual histological margins.

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Section: Methodsmentioning

confidence: 99%

Intraoperative Lung Ultrasound (ILU) for the Assessment of Pulmonary Nodules

et al. 2021

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“…Axillary thoracotomy is a surgical method that approaches the axillary area, which includes the first rib or second and third rib resection, and smaller muscle transections are made compared to those in the original thoracotomy, which requires transection of the latissimus dorsi or serratus anterior muscle[ 5 ]. It is mainly one of the surgical methods for the apical lung, pleural cavity, thoracic cavity, heart, and esophagus and is performed by exposing the axilla by flexing the ipsilateral arm in the lateral decubitus position.…”

Section: Introductionmentioning

confidence: 99%

Recovery of brachial plexus injury after bronchopleural fistula closure surgery based on electrodiagnostic study: A case report and review of literature

Go¹,

Kim²,

Kim³

et al. 2022

World J Clin Cases

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BACKGROUND Axillary thoracotomy and muscle flap are muscle- and nerve-sparing methods among the surgical approaches to bronchopleural fistula (BPF). However, in patients who are vulnerable to a nerve compression injury, nerve injury may occur. In this report, we present a unique case in which the brachial plexus (division level), suprascapular, and long thoracic nerve injury occurred after BPF closure surgery in a patient with ankylosing spondylitis and concomitant multiple joint contractures. CASE SUMMARY A 52-year-old man with a history of ankylosing spondylitis with shoulder joint contractures presented with right arm weakness and sensory impairment immediately after axillary thoracotomy and latissimus dorsi muscle flap surgery for BPF closure. During the surgery, the patient was positioned in a lateral decubitus position with the right arm hyper-abducted for approximately 6 h. Magnetic resonance imaging and ultrasound revealed subclavius muscle injury or myositis with brachial plexus (BP) compression and related neuropathy. An electrodiagnostic study confirmed the presence of BP injury involving the whole-division level, long thoracic, and suprascapular nerve injuries. He was treated with medication, physical therapy, and ultrasound-guided injections. Ultrasound-guided steroid injection at the BP, hydrodissection with 5% dextrose water at the BP and suprascapular nerve, and intra-articular steroid and hyaluronidase injection at the glenohumeral joint were performed. On postoperative day 194, the pain and arm weakness were resolved, and a follow-up electrodiagnostic study showed marked improvement. CONCLUSION Clinicians should consider the possibilities of multiple nerve injuries in patients with joint contracture, and treat each specific therapeutic target.

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