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P osterolateral t horacotomy , muscle sparing posterolateral thoracotomy , anterior t horacotomy in primary lung cancer : comperison of pre-postoperative results. Serhan Tanju, Sedat Ziyade, Erkan Kaba, Murat Sarıçam, Alper Toker, Sukru Dilege
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Posterolateral thoracotomy, muscle sparing posterolateral thoracotomy, anterior thoracotomy in primary lung cancer: comperison of pre-postoperative results Serhan Tanju, Sedat Ziyade, Erkan Kaba, Murat Sarıçam, Alper Toker, Sukru Dilege Istanbul University Istanbul Faculty of Medicine Department of Thoracic Surgery
Aim • Resection in primary lung cancer • Posterolateral thoracotomy • Posterolateral muscle sparing thoracotomy • Anterior thoracotomy
Material and Method • January 2003-December 2004 • Randomized, 75 patient • Group 1 (n=25):Posterolateral thoracotomy • Group 2 (n=25):Posterolateral muscle sparing thoracotomy • Group 3 (n=25):Anterior thoracotomy
Group 1Posterolateral thoracotomy • Lateral decubitus • Trapezius-latissimus dorsi, rhomboid- serratus anterior
Group 2muscle sparing posterolateral thoracotomy • Lateral decubitus • Subcuteneus flep • Between Latissimus dorsi trapezius m. • Latissimus dorsi-toracolumbar fasia
Group 3Anterior thoracotomy • 450 lateral decubitus • Muscle sparing Latissimus dorsi-serratus anterior • Intrathoracic paravertebral plane
Material Method • Age • Gender, • Lenght of insicion, • Duration of Thoracotomy, • Resection type, • Duration pf hospital stay, • VAS, • Location and stage of tumor • Mann Whitney U Test
Eclusion criterias • T3-chest wall • T4-Central tumor • Fractured rib • pneumonectomy
Group 1 Stage I:15 Stage II: 5 Stage III: 4 Grup 2 Stage I:16 Stage II: 6 Stage III: 3 Grup 3 Stage I:18 Stage II: 3 Stage III: 4 Results (stage of the tumor)
Conclusion • Anterior thoracotomy vs posterolateral thoracotomy • VAS • Duration of thoracotomy • Duration of hospital stay • Lenght of incision
Wound infection/seroma Low pain;respiratuar exercise BPF/ muscle transposition Postop late period muscle strenght Rib fractured Expojour - Head-light Asistant Major hemoraghe Plorodezis Endo-enstrümantation Conclusion anterior thoracotomy