A meta-analysis comparing muscle-sparing and posterolateral thoracotomy

Area of Science:

• Thoracic Surgery
• Surgical Techniques
• Comparative Effectiveness Research

Background:

• Posterolateral thoracotomy is a traditional approach for open thoracic operations.
• Concerns exist regarding postoperative shoulder function and pain associated with posterolateral thoracotomy.

Purpose of the Study:

• To compare the outcomes of muscle-sparing thoracotomy versus posterolateral thoracotomy after open thoracic operations.
• To evaluate differences in shoulder function, pain, and complication rates between the two surgical approaches.

Main Methods:

• A systematic review and meta-analysis of twelve randomized controlled trials.
• Inclusion of 571 patients in the muscle-sparing thoracotomy group and 512 in the posterolateral thoracotomy group.

Main Results:

• Muscle-sparing thoracotomy demonstrated significantly improved shoulder internal rotation (WMD = -1.28, p = 0.03).
• Patients undergoing muscle-sparing thoracotomy reported lower pain scores on day 7 (WMD = -0.76, p = 0.002).
• A significantly higher rate of seroma formation was observed in the muscle-sparing thoracotomy group (OR = 8.26, p = 0.002).

Conclusions:

• Muscle-sparing thoracotomy is recommended for patients prioritizing rapid shoulder function recovery.
• The increased risk of seroma formation with muscle-sparing thoracotomy requires careful consideration and management.