Background: Standard thoracotomy necessitates division of thoracic large muscles leading to pain and impaired respiratory movements; muscle sparing postero-lateral thoracotomy has been suggested as an alternative to reduce the aforementioned effect. The aim of this study was to compare muscle saving posterolateral thoracotomy with standard thoracotomy.
Methods: This study was a clinical trial. All patients who were candidates for elective thoracotomy were included and divided into two groups of muscle saving thoracotomy and standard thoracotomy randomly. Required time for opening and closing the chest, amount of prescribed narcotics, shoulder movements (flexion, extension, abduction and internal rotation), pulmonary function (FVC, FEV1, VC), development of seroma, and duration of hospitalization were assessed. Shoulder movements and pulmonary function were measured immediately before operation and 7 days later while pain measured in 1^st and 7^th post-operative days.
Results: 60 patients (42 males) entered the study and there were no significant differences regarding age and sex distribution between two groups (p>0.05). Mean duration of opening the chest in muscle saving thoracotomy was significantly longer than standard procedure while the duration of closing the chest wall was significantly shorter in muscle saving thoracotomy (p<0.05). FVC and range of motion of the shoulder were higher and post-operative pain was lesser in muscle saving thoraocotomy than standard thoracotomy (p<0.05). There were no significant differences regarding prescribed narcotics and duration of hospital stay (p>0.05). Seroma developed in 13% (n=4) of muscle saving group.
Conclusion: Muscle saving thoracotomy can be used as an appropriate alternative for standard postero-lateral thoracotomy in elective thoracic operations.