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首页> 外文期刊>Interactive cardiovascular and thoracic surgery >Feasibility of latissimus dorsi and serratus anterior muscle-sparing vertical thoracotomy in general thoracic surgery
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Feasibility of latissimus dorsi and serratus anterior muscle-sparing vertical thoracotomy in general thoracic surgery

机译：背阔肌和锯肌前肌保留垂直胸廓切开术在普通胸外科中的可行性

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Postero-lateral thoracotomy has many complications such as postoperative pain, limitation in the motion of the shoulder, decreasing pulmonary function from immobilization, increasing lung atelectasis from over-use of analgesia, and increasing pulmonary morbidity, especially in elderly patients. So, muscle-sparing thoracotomy appears to be a good alternative. But it has also many disadvantages such as seroma and the needs for drains, limitation of an accessible operative field, and difficulties with risky procedures. We have modified muscle-sparing vertical thoracotomy. We performed 1.34 procedures on 131 patients from October 2000 to September 2003, including 15 cases of esophageal cancer, 95 cases of lung cancer, and 24 cases of other disease. Operative procedures were lobectomy in 74 cases, bilobectomy in 12 cases, pneumonectomy in 10 cases, wedge resection in 8 cases, decortication in 2 cases, Ivor Lewis procedure in 13 cases, and others in 15 cases. There was no occurrence of wound infection, arrrhythmia, fibrillation, and subcutaneous seroma except the first two cases. We had seven reoperations (two postoperative bleeding, three postpoperative BPF, one EGstomy leak, one RML torsion) and four operative mortalities (one postpneumonectomy BPF, two pneumonia, one heart failure). Our muscle-sparing vertical thoracotomy can be done safely in most thoracic surgery including lung and esophageal cancer, therefore it is a feasible procedure.
机译：后外侧开胸手术有许多并发症，例如术后疼痛，肩部运动受限，固定不动导致肺功能降低，过度使用止痛剂导致肺不张增加以及肺部发病率增加，特别是在老年患者中。因此，保留肌肉的开胸手术似乎是一个很好的选择。但是它也有许多缺点，例如血清肿和引流管的需要，手术区域的局限性以及高风险手术的困难。我们修改了保留肌肉的垂直开胸手术。从2000年10月至2003年9月，我们对131例患者进行了1.34例手术，其中包括15例食道癌，95例肺癌和24例其他疾病。手术方式为肺叶切除术74例，双叶切除术12例，肺切除术10例，楔形切除术8例，剥脱术2例，艾佛尔·刘易斯手术13例，其他15例。除前两例外，未发生伤口感染，心律不齐，纤颤和皮下血清肿。我们进行了七次再次手术（两次术后出血，三次术后BPF，一次EGstomy渗漏，一次RML扭转）和四次手术死亡率（一次肺切除术后BPF，两次肺炎，一例心力衰竭）。我们的保留肌肉的垂直开胸手术可以在大多数胸外科手术中安全完成，包括肺癌和食道癌，因此这是一个可行的手术。

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