Midline sternotomy for the treatment of primary pulmonary neoplasms

Twenty-eight of 160 patients operated on for suspected primary pulmonary neoplasms from July 1980 through June 1983 were approached by median sternotomy. Patients who underwent sternotomy had more general risk factors and more severely impaired pulmonary function than those who underwent posterolateral thoracotomy, but the morbidity and postoperative hospital stay were similar in the two groups. The amount of analgesic required for control of postoperative pain in the sternotomy patients was considerably less than that required for the thoracotomy patients. We believe that transternal resection is a reasonable alternative to posterolateral thoracotomy in the surgical treatment of primary pulmonary neoplasms, particularly peripheral neoplasms in the upper and middle lobe regions. It may be the preferred incision in the surgical treatment of impaired pulmonary function.