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Sparing the serratus anterior muscle: A contemporary trend
in thoracic surgery
G. Lazopoulos, P. Tomos, Ch. Kotoulas, G. Papamichalis, D. Pousios, M. Konstantinou,
A. Lioulias
SUMMARY: The standard posterolateral thoracotomy has been used for
many decades in a great number of thoracic operations. The procedure during
which the lateral thoracic wall muscles the latissimus dorsi and the serratus
anterior are being spared, represents an alternative approach.
Since 1997, our department undertook 53 posterolateral thoracotomies in a random
sample of patients, whereas the serratus anterior muscle, as well as the greatest
part of the latissimus dorsi muscle, have been spared. During this type of thoracotomy,
the skin incision is identical to the standard procedure, the latissimus dorsi
muscle is partially divided and the serratus anterior muscle is mobilized, after
its posterior margin is identified and his posterior fascia divided and thereafter,
the hemithorax is entered through the 4th, 5th or 6th interspace.
By sparing the serratus anterior muscle, as well as the greatest part of the
latissimus dorsi muscle, faster patient recovery, while postoperative pain and
use of analgetics, as well as duration of hospital stay are descreased. The
time required for exposure of the chest cavity is increased, resulting in a
decrease of closing time.
In conclusion, the muscle-sparing posterolateral thoracotomy technique offers
many advantages regarding postoperative patient recovery, pain, as well as
duration and cost effectiveness of hospital stay. We strongly believe that it
may be a reasonable alternative to the standard posterolateral approach.
Pneumon 2001, 14(1):47-50
Key words: Posterolateral thoracotomy incision, latissimus dorsi muscle,
serratus anterior muscle, thoracic wall, muscle-sparing techniques.
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