Comparison of late pulmonary function after posterolateral and muscle-sparing thoracotomy

Muscle-sparing thoracotomy incisions have received considerable recent attention. There have, however, been few clinical and functional comparisons between the various approaches. The present study assessed early clinical results and late pulmonary function changes in 79 patients undergoing pulmonary operations by posterolateral, limited lateral, or transverse axillary thoracotomy. With the exception of wound seromas in the limited lateral group, there was no difference in rates of death or complications. Patients with muscle-sparing incisions showed significantly better late preservation of forced vital capacity and flow during the midportion of the forced vital capacity but not of other pulmonary volumes and flows. We conclude that limited incisions may result in slightly better late pulmonary function, but that the differences are small and of no apparent clinical advantage in the average patient.