ECONOMIC LONGITUDINAL LATERAL POSTERIOR THORACOTHOMY - MINIMALLY INVASIVE OPTION IN PULMONARY RESECTIONS

Background. Pulmonary resections are usually performed through postero lateral thoracotomy. However this approach has been associated largely with early and late incidence of postoperative morbidity. Several lat eral chest approaches have been reported in the medical literature wit h the objective to decrease morbidity due to thoracotomy. The aim of t his study was to evaluate the results of pulmonary resection, performe d by means of a minor thoracotomy in the posterior axillary region. Me thods. The skin incision was longitudinal and scapular; shoulder and c hest wall muscles were not cut, a subperiosteally lateral portion of r ib was removed and the thoracic wall was opened in the rib bed. The ap proach in this place allowed a smaller skin incision, skin naps were n ot necessary and the chest wall opening stayed in a better position in relation to the pulmonary hilum, facilitating the exposition of its a nterior and posterior faces. From January 1994 to December 1996 sevent y-eight consecutively non-selected patients underwent eighty surgical procedures for several kinds of pulmonary resections. Results. All sur gical procedures occurred without difficulties and with a lower number of postoperative complications. A very good aesthetic result was reac hed. Conclusions. We believe this chest approach may be a good choice for pulmonary resection.