[Clinical value of modified thoracotomy for thoracic tumors]

To minimize the morbidity of thoracotomy for thoracic tumors.

From Oct. 2000 to Sept. 2001, 40 patients ( male 26, female 14, with age of 20-79 years old) underwent thoracotomies, in which 15 had lung cancer, 1 carcinoid, 1 infectious cyst of lung, 2 pulmonary inflammatory pseudotumor, 2 thymoma, and 19 esophageal carcinoma. Inframammary incision, muscle-sparing thoracotomy and serratuas-sparing posterolateral thracotomy were done to conduct lobectomy or bilobectomy in 17, segmentectomy in 1, middle lobectomy plus sleeve resection of bronchus media in 1, resection of thymoma in 2 and esophagectomy in 19. A conventional posterolateral thoracotomy group was set as control. Comparative parameters included postoperative pain and shoulder function. The lobectomy cases in study group were even compared the preoperative and postoperative FEV1 and length of hospitalization with conventional posterolateral thoracotomies. Statistic t test and Chi-Square test were used to exam the data.

Compared with the conventional posterolateral thoracotomy, the acute and chronic postoperative pain and shoulder function in study group were remarkablely improved on clinical observation. Length of hospitalization was shortened and early pulmonary function was significantly improved when adjusted with age, number of resected lobe and the operated side.

The morbidity of thoracotomy for thoracic tumors can be minimized by reasonable incision-designing based on the stage of disease and topical anatomy.