Economic longitudinal lateral posterior thoracothomy. Minimally invasive option in pulmonary resections

Pulmonary resections are usually performed through posterolateral thoracotomy. However this approach has been associated largely with early and late incidence of postoperative morbidity. Several lateral chest approaches have been reported in the medical literature with the objective to decrease morbidity due to thoracotomy. The aim of this study was to evaluate the results of pulmonary resection, performed by means of a minor thoracotomy in the posterior axillary region.

The skin incision was longitudinal and scapular; shoulder and chest wall muscles were not cut, a subperiosteally lateral portion of rib was removed and the thoracic wall was opened in the rib bed. The approach in this place allowed a smaller skin incision, skin flaps were not necessary and the chest wall opening stayed in a better position in relation to the pulmonary hilum, facilitating the exposition of its anterior and posterior faces. From January 1994 to December 1996 seventy-eight consecutively non-selected patients underwent eighty surgical procedures for several kinds of pulmonary resections.

All surgical procedures occurred without difficulties and with a lower number of postoperative complications. A very good aesthetic result was reached.

We believe this chest approach may be a good choice for pulmonary resection.