Askarpour Shahnam, Peyvasteh Mehran, Ashrafi Amir, Dehdashtian Masoud, Malekian Arash, Aramesh Mohammad-Reza
Department of Pediatric Surgery, Imam Khomeini Hospital.
Department of Neonatalogy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khouzestan, Iran.
Arq Bras Cir Dig. 2018;31(2):e1365. doi: 10.1590/0102-672020180001e1365. Epub 2018 Jul 2.
The muscle-sparing thoracotomy (MST) has not yet been thoroughly studied and assessed in comparison to the traditional thoracotomy method in newborns.
To compare the outcomes of MST and standard posterolateral thoracotomy (PLT) in newborns.
Randomized, controlled, double-blind trial on 40 neonates with esophageal atresia, comparing the time of beginning a surgery until seeing the pleura, the duration of hospitalization in the neonatal intensive care unit, the time in ventilator, the time of returning the shoulder function, the time of returning the Moro reflex, and the mortality between the two techniques.
The data showed no differences between the two groups in basic information (weight, height, gender, numbers of prematurity neonates and caesarean). The results on the size of the scar in the MST group was significantly lower than in the PLT group. Also, the time of returning the shoulder function in MST group was earlier than in PLT group. There were no significant differences in the duration since the beginning the surgery to see the pleura, the time of being hospitalized in intensive unit, the time that the infant required ventilator, returning time of the Moro reflex in 1st and 3rd months after the operation, and the mortality rates between MST and PLT groups.
It seems that the advantages of using MST over PLT procedure in neonates include the earlier shoulder function recovery and also superior cosmetic results.
与传统开胸手术方法相比，保留肌肉开胸术（MST）在新生儿中的研究和评估尚未充分。
比较新生儿MST和标准后外侧开胸术（PLT）的手术效果。
对40例食管闭锁新生儿进行随机、对照、双盲试验，比较两种手术从开始手术到见到胸膜的时间、新生儿重症监护病房的住院时间、使用呼吸机的时间、肩部功能恢复时间、拥抱反射恢复时间以及两种技术的死亡率。
数据显示两组在基本信息（体重、身高、性别、早产儿数量和剖宫产数量）方面无差异。MST组的瘢痕大小结果显著低于PLT组。此外，MST组的肩部功能恢复时间早于PLT组。MST组和PLT组在开始手术到见到胸膜的时间、在重症监护病房的住院时间、婴儿需要呼吸机的时间、术后第1个月和第3个月拥抱反射的恢复时间以及死亡率方面无显著差异。
在新生儿中使用MST优于PLT手术的优势似乎包括肩部功能恢复更早以及美容效果更佳。
