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DOI: 10.1055/s-0030-1249829
© Georg Thieme Verlag KG Stuttgart · New York
Isokinetic Muscle Strength after Thoracotomy: Standard vs. Muscle-Sparing Posterolateral Thoracotomy
Publication History
received Dec. 1, 2009
Publication Date:
02 August 2010 (online)
![](https://www.thieme-connect.de/media/thoracic/201005/lookinside/thumbnails/10.1055-s-0030-1249829-1.jpg)
Abstract
Background: The aim of the study was to compare the effects of conventional posterolateral thoracotomy and muscle-sparing posterolateral thoracotomy on pulmonary and muscle strength. Methods: From January 2003 to December 2004, 50 randomized patients with a diagnosis of primary lung cancer underwent pulmonary resection. The patients were divided into two groups: Group I (n = 25) underwent conventional posterolateral thoracotomy, while Group II (n = 25) had muscle-sparing thoracotomy. The groups were compared in terms of shoulder abduction/adduction isokinetic muscle strength and respiratory muscle strength. Results: A comparison of maximal expiratory pressure and maximal inspiratory pressure preoperatively and postoperatively and of maximal expiratory pressure and maximal inspiratory pressure preoperatively and at 3 months postoperatively showed statistically significant differences (p < 0.05). Conclusion: For the preservation of muscle strength, especially in patients whose jobs involved manual work, muscle-sparing posterolateral thoracotomy should be the first choice rather than conventional thoracotomy. Moreover, if necessary, the latissimus dorsi muscle can be used more extensively as a flap after muscle-sparing posterolateral thoracotomy procedures.
Key words
thoracic surgery - posterolateral thoracotomy - muscle sparing - surgery/incisions - thoracotomy - rehabilitation - pulmonary function
References
- 1 Hazelrigg S R, Landreneau R J, Boley T M et al. The effect of muscle-sparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain. J Thorac Cardiovasc Surg. 1991; 101 394-401
-
2 Murthy S C, Rice T W.
Thoracic incisions. Pearson FG, Cooper JD, Deslauriers J, Ginsberg JR, Hiebert C, Patterson GA, Urschel HC Thoracic surgery. 2nd ed. New York; Churchill Livingstone 2002: 120-139 -
3 Dvir Z.
Isokinetics. Hardware, test parameters, and issues in testing. Dvir Z Muscle testing, interpretation and clinical applications. 2nd ed. New York; Churchill Livingstone 1995: 1-79 -
4 Perrin H D.
Isokinetic instrumentation. Perrin HD Isokinetic exercise and assessment. West Yorkshire; Human Kinetics Publishers 1993: 1-212 -
5 Basyigit I.
Spirometrik inceleme. Ilgazlı A, Cağlar T Solunum Fonksiyon Testleri ve Klinik Kullanımları. Istanbul; Nobel Tıp Kitapevleri 2004: 31-51 - 6 Nomori H, Horio H, Iga R, Shouyama Y, Kobayashi R. Postoperative changes of maximum inspiratory and expiratory pressures in 3 pneumonia cases occurring after surgery for empyema. Kyobu Geka. 1996; 6 445-448
- 7 Nomori H, Kobayashi R, Fuyuno G, Morinaga S, Yashima H. Preoperative respiratory muscle training. Assessment in thoracic surgery patients with special reference to postoperative pulmonary complications. Chest. 1994; 6 1782-1788
- 8 Furrer M, Rechsteiner R, Eigenmann V, Signer C, Althaus U, Ris H B. Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints. Eur J Cardiothorac Surg. 1997; 12 82-87
- 9 Nakata M, Saeki H, Yokoyama N, Kurita A, Takiyama W, Takashima S. Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg. 2000; 70 938-941
- 10 Mayer F, Horstmann T, Rocker K, Heitkamp H C, Dickhuth H H. Normal values of isokinetic maximum strength, the strength/velocity curve, and the angle at peak torque of all degrees of freedom in the shoulder. Int J Sports Med. 1994; 15 19-25
- 11 Akçalı Y, Demir H, Tezcan B. The effect of standard posterolateral versus muscle-sparing thoracotomy on multiple parameters. Ann Thorac Surg. 2003; 76 1050-1054
- 12 Van Meeteren J, Roebroek M E, Stam H J. Test-retest reliability in isokinetic muscle strength measurements of the shoulder. J Rehabil Med. 2002; 34 91-95
- 13 Mayer F, Horstmann T, Kranenberg U, Rocker K, Dickhuth H H. Reproducibility of isokinetic peak torque and angle at peak torque in the shoulder joint. Int J Sports Med. 1994; 15 26-31
- 14 Kutlu C A, Akin H, Olcmen A, Biliciler U, Kayserilioğlu A, Ocmen M. Shoulder-girdle strength after standard and lateral muscle-sparing thoracotomy. Thorac Cardiov Surg. 2001; 49 112-114
- 15 Khan I F, McManus K G, McCraith A, McGuigan J A. Muscle-sparing thoracotomy: a biomechanical analysis confirms preservation of muscle strength but no improvement in wound discomfort. Eur J Cardiothorac Surg. 2000; 18 656-661
Dr. Serhan Tanju
Department of Thoracic Surgery
Istanbul Universty Istanbul Medical School
Capa
Millet St
34390 Istanbul
Turkey
Email: drstanju@hotmail.com