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The Incidence of Winged Scapula after Thoracic Cancer Surgery: A Prospective Cohort Study
Luiz Felipe Nevola Teixeira1, Fabio Sandrin1, Ruy Fernando Kuenzer Caetano da Silva2
1Physiotherapy Department, IEO, European Institute of Oncology IRCCS, Milan, Italy.
The Thoracic and Cardiovascular Surgeon
|May 3, 2024
Summary
Serratus anterior palsy, or winged scapula (WS), affects 27.8% of lung cancer surgery patients. Longer surgeries and specific procedures increase WS risk, with many cases persisting long-term.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Neurosurgery
Background:
- Lung cancer surgery is a primary treatment for early and locally advanced disease.
- Serratus anterior palsy, leading to winged scapula (WS), is a potential iatrogenic complication of thoracic surgery.
- The precise incidence of WS following lung cancer surgery remains unclear.
Purpose of the Study:
- To determine the incidence of winged scapula (WS) in patients undergoing lung cancer surgery.
- To identify risk factors associated with WS development after thoracic procedures.
Main Methods:
- Retrospective analysis of prospectively collected data from lung cancer surgery patients (March 2013 - January 2014).
- Physical evaluation for WS conducted pre-operatively, post-operatively, at discharge, and 1-year follow-up.
Main Results:
- Out of 485 patients, 135 (27.8%) developed WS.
- Factors significantly associated with WS included longer operative time, type of surgery, lymphadenectomy, and neoadjuvant treatment.
- Multivariable analysis confirmed type of surgery as a significant predictor of WS.
- At 1-year follow-up, 41.6% of patients continued to exhibit WS.
Conclusions:
- The incidence of WS in lung cancer surgery is significant and potentially underdiagnosed.
- Improved assessment and patient education regarding WS are necessary.
- Discussing surgical strategies, particularly when avoiding minimally invasive approaches, may help reduce WS incidence.
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