THORACOPLASTY IN THE CONTEXT OF CURRENT SURGICAL PRACTICE

Although widely employed for well over a century as a procedure for re ducing the capacity of the thoracic cavity, thoracoplasty in current p ractice has become a rarity. A retrospective analysis of 37 patients ( 29 men, 8 women) who underwent the procedure under the care of one tho racic surgeon in a 16-year period provides the basis for this presenta tion. Ages ranged from 23 to 82 years with a mean age of 58 +/- 12.8. The mean follow-up was 8.5 years. Nineteen patients underwent the proc edure for complications after lung resection for lung cancer. There we re four perioperative deaths in this group (21.1%) and 6 long-term sur vivors (31.6%). Eighteen patients without lung cancer underwent thorac oplasty as a planned treatment or for complications. There were no per ioperative deaths, two late deaths, and 16 long-term survivors (88.9%) in the group. In the entire series, the overall perioperative mortali ty rate was 10.8% with no major long-term morbidity. Although proper t iming and proper patient selection are essential in the use of thoraco plasty as a procedure to cope with the septic complications of lung ca ncer resection, it is overall a safe and successful procedure that has a relatively low mortality and that leads to considerable improvement in quality of life.