The Annals of Thoracic Surgery, Vol 58, 712-717, Copyright © 1994 by The Society of Thoracic Surgeons
Video-assisted minithoracotomy versus muscle-sparing thoracotomy for performing lobectomy
R Giudicelli, P Thomas, T Lonjon, J Ragni, N Morati, R Ottomani, PA Fuentes, H Shennib and M Noirclerc
Department of Thoracic Surgery and Lung Transplantation, Sainte- Marguerite University Hospital, Marseilles, France.
We prospectively analyzed the outcome of lobectomy in a cohort of 67
patients. Operative time, postoperative pain, pulmonary function, and early
outcome were compared between the patients undergoing video- assisted
techniques (n = 44) and those undergoing standard muscle- sparing
procedures (n = 23). Pain was quantified daily throughout the first week
using the visual analog scale. The forced expiratory volume in 1 second and
the forced vital capacity were measured at days 2, 4, and 8
postoperatively. The operative time was significantly longer (p < 0.02)
and the postoperative pain was significantly less (p < 0.006) in the
group undergoing video-assisted procedures. Pain-related morbidity, the
mean duration of air leaks, the duration of chest tube placement, and the
hospital stay were all less in the video-assisted group, but the
differences did not reach statistical significance. However, the impairment
in pulmonary function and the overall morbidity were identical for the two
groups. Based on our findings, we conclude that video-assisted
minithoracotomy is a safe and reliable approach for performing lobectomies,
and that the decreased postoperative pain associated with this minimally
invasive approach does not result in preserved pulmonary function and
significantly reduced morbidity when compared with a muscle-sparing
thoracotomy.
