Pleurectomy Through the Triangle of Auscultation for Treatment of Recurrent Pneumothorax in Younger Patients

Neurophysiologic assessment of nerve impairment in posterolateral and muscle-sparing thoracotomy

“…Although several studies demonstrated that muscle-sparing thoracotomy is less painful than posterolateral [6][7][8][9][10][11][12][13] thoracotomy, we have little information on the pathophysiologic basis of this difference. In this study we were mainly interested in analyzing postthoracotomy pain lasting for several weeks after operation and in assessing the role of nerve damage as the cause of the long-lasting pain.…”

“…[4][5][6] By contrast, muscle-sparing thoracotomy causes less pain and fewer complications. [6][7][8][9][10][11][12][13] This is because muscle-sparing thoracotomy approaches the lung through the auscultatory triangle with a relatively small skin incision and no resection of the muscles. On the basis of these considerations, we decided to assess the degree of intercostal nerve impairment in posterolateral and muscle-sparing thoracotomy by means of electromyography (EMG) and somatosensory-evoked potentials (SEP) and by assessing tactile and pain thresholds to electrical stimulation on the operative scar.…”