1992 Volume 6 Issue 6 Pages 647-654
We performed latissimus dorsi muscle-sparing thoracotomy for patients with primary lung cancer and evaluated its usefulness.
Fifty-three primary lung cancer patients undergoing thoracotomy from September 1988 to July 1989 were randomized into 2 groups : a latissimus dorsi muscle-sparing thoracotomy group (sparing group : n= 23 + 8 consecutive cases) and a standard postero-lateral thoracotomy group (dissecting proup : n=22).
With the use of 2 retractors, reasonably good exposure for lymph node dissection of the upper mediastinum was obtained in the sparing group.
Postoperative differences in pulmonary function could not be found between the two groups ; postoperative analgesic use was less (but not significantly so) in the sparing group. Subcutaneous fluid collection (seroma) after removal of the subcutaneous drains developed in 4 patients (12.9%) in the sparing group, but it was easily treated by repeated bedside needle aspirations.
We concluded that latissimus dorsi muscle-sparing thoracotomy has some advantages in less postoperative pain and better cosmetic results. but there were also some disadvantages in it, so we are not going to adopt muscle-sparing thoracotomy as the standard method for primary lung cancer patients.