ELECTROMYOGRAPHIC EVALUATION OF THE SPARED SERRATUS ANTERIOR AFTER POSTEROLATERAL THORACOTOMY

Postero-lateral thoracotomy is the standard access in thoracic surgery , and can be carried out dividing or preserving the serratus anterior muscle. This last method, besides its advantages, is still a matter of discussion, in fact traction has been claimed to cause severe muscula r damage equal to section. We have studied 20 patients (16 males and 4 females, mean age 63 years), who underwent postero-lateral thoracotom y sparing the serratus anterior, after 6 months from surgery, both cli nically and by means of electromyography (EMG), to evaluate the functi onal status of the spared muscles. In 4 cases (20%) there wasn't any n eurogenic damage nor clinical evidence of winging scapula; 3 cases (15 %) had medium neurogenic damage, The remaining 13 (65%) cases had a me dium neurogenic damage and only one patient showed a winging scapula, nevertheless being able to Lift the arm to shoulder level. Our data co nfirmed that retraction during surgery does not damage the serratus an terior, leaving a functionally valid muscle.