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Initial experience with two sequential anterolateral thoracotomies for bilateral lung transplantation
S Taghavi1, T Bîrsan, R Seitelberger
1Division of Cardiothoracic Surgery, University of Vienna, Vienna General Hospital, Austria.
The Annals of Thoracic Surgery
|June 4, 1999
Summary
Two separate anterolateral thoracotomies offer a less invasive approach for bilateral sequential lung transplantation (BLTX), improving postoperative recovery compared to the standard clamshell incision.
Area of Science:
- Thoracic Surgery
- Transplantation Medicine
- Minimally Invasive Procedures
Background:
- The standard clamshell incision for bilateral sequential lung transplantation (BLTX) is associated with significant morbidity.
- Alternative surgical approaches are being explored to reduce patient trauma.
Purpose of the Study:
- To evaluate the safety and efficacy of bilateral sequential anterolateral thoracotomies as a less invasive alternative to the clamshell incision for BLTX.
Main Methods:
- A prospective study of 13 patients undergoing BLTX with sequential anterolateral thoracotomies (Group A).
- Comparison with 8 historical control patients who underwent BLTX via clamshell incision (Group B).
- Outcomes assessed included intraoperative complications, ischemic times, and postoperative vital capacity.
Main Results:
- No intraoperative complications were observed in either group.
- Cold ischemic times for both lungs were comparable between the two groups.
- Patients in Group A demonstrated significantly improved postoperative vital capacity during the third postoperative week compared to Group B.
Conclusions:
- Bilateral sequential anterolateral thoracotomies are a safe and less invasive option for BLTX, particularly in patients with large chest volumes.
- This approach minimizes operative trauma and enhances early postoperative functional recovery.
- It also offers the advantage of preventing potential spread of unilateral complications to the contralateral pleural cavity.