Effects of approaches to thoracotomy on pulmonary function after lung resection

Abstract

To clarify the effects of approach methods to thoracotory on lung function after lobectomy, the postoperative lung function of 3 groups receiving different approaches to thoracotomy were compared ; these were standard posterolateral (n=34), serratus anterior muscle-sparing (n=11), and muscle-sparing thoracotomy (n=10). The predicted postoperative values were calculated from preoperative lung function and pulmonary perfusion scan ratio, and compared them with the actual postoperative values. Good correlaions between the predicted values and the actual values in the 3 groups were noted. In the serratus anterior muscle-sparing and muscle-sparing thoracotomy groups, the ratios of actual values/predicted values of TLC, FRC and ERV were significantly higher than those of posterolateral thoracotomy group. The tendency for serratus anterior muscle-sparing or musce-sparing methods to preserve forced expiratory parameters (FVC, FEV_1.0, and peak flow) compared to posterolateral incision was observed. We conclude that the muscle-sparing approach to thoracotomy is a useful method to preserve the lung function after lobectomy.