Ziyade S, Baskent A, Tanju S, Toker A, Dilege S
Department of Thoracic Surgery, Istanbul Universty Istanbul Medical School, Istanbul, Turkey.
Thorac Cardiovasc Surg. 2010 Aug;58(5):295-8. doi: 10.1055/s-0030-1249829. Epub 2010 Aug 2.
The aim of the study was to compare the effects of conventional posterolateral thoracotomy and muscle-sparing posterolateral thoracotomy on pulmonary and muscle strength.
From January 2003 to December 2004, 50 randomized patients with a diagnosis of primary lung cancer underwent pulmonary resection. The patients were divided into two groups: Group I (n=25) underwent conventional posterolateral thoracotomy, while Group II (n=25) had muscle-sparing thoracotomy. The groups were compared in terms of shoulder abduction/adduction isokinetic muscle strength and respiratory muscle strength.
A comparison of maximal expiratory pressure and maximal inspiratory pressure preoperatively and postoperatively and of maximal expiratory pressure and maximal inspiratory pressure preoperatively and at 3 months postoperatively showed statistically significant differences (P<0.05).
For the preservation of muscle strength, especially in patients whose jobs involved manual work, muscle-sparing posterolateral thoracotomy should be the first choice rather than conventional thoracotomy. Moreover, if necessary, the latissimus dorsi muscle can be used more extensively as a flap after muscle-sparing posterolateral thoracotomy procedures.
本研究的目的是比较传统后外侧开胸术和保留肌肉后外侧开胸术对肺功能和肌肉力量的影响。
2003年1月至2004年12月，50例确诊为原发性肺癌的患者接受了肺切除术。患者被分为两组：第一组（n=25）接受传统后外侧开胸术，而第二组（n=25）接受保留肌肉开胸术。比较两组的肩部外展/内收等速肌力和呼吸肌力。
术前和术后最大呼气压力和最大吸气压力的比较，以及术前和术后3个月最大呼气压力和最大吸气压力的比较显示出统计学上的显著差异（P<0.05）。
为了保留肌肉力量，特别是对于工作涉及体力劳动的患者，保留肌肉后外侧开胸术应是首选而非传统开胸术。此外，如有必要，在保留肌肉后外侧开胸术后，背阔肌可更广泛地用作皮瓣。
