VIDEO-ASSISTED MINITHORACOTOMY VERSUS MUSCLE-SPARING THORACOTOMY FOR PERFORMING LOBECTOMY

We prospectively analyzed the outcome of lobectomy in a cohort of 67 p atients. Operative time, postoperative pain, pulmonary function, and e arly outcome were compared between the patients undergoing video-assis ted techniques (n = 44) and those undergoing standard muscle-sparing p rocedures (n = 23). Pain was quantified daily throughout the first wee k using the visual analog scale. The forced expiratory volume in 1 sec ond and the forced vital capacity were measured at days 2, 4, and 8 po stoperatively. The operative time was significantly longer (p < 0.02) and the postoperative pain was significantly less (p < 0.006) in the g roup 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 impai rment in pulmonary function and the overall morbidity were identical f or the two groups. Based on our findings, we conclude that video-assis ted minithoracotomy is a safe and reliable approach for performing lob ectomies, and that the decreased postoperative pain associated with th is minimally invasive approach does not result in preserved pulmonary function and significantly reduced morbidity when compared with a musc le-sparing thoracotomy.