Is the function of the serratus anterior muscle disturbed following division during a standard thoracotomy?

In a prospective study the functional results after dissection dr preservat ion of the serratus anterior muscle in the postero-lateral standard thoraco tomy were evaluated. In 14 patients of our clinic with dissection and sutur e and in 14 patients with preservation of the serrafus muscle the muscle fu nction was assessed and compared preoperatively, within the first two post- operative weeks, and three months after the operation by the same physiothe rapists. The two groups were blinded in regard to age, original disease, an d mode of intervention. We compared the wing position of the scapula in the sitting position and the positioning of the scapula at fixation of the sho ulder joint in the sitting and in the supine position. Using a four-grade f unction assessment scheme, both groups obtained the same functional results . There was no seroma in either group. After 2.8 (2.5 to 3.0) years all the surviving patients described symmetric functional conditions. We therefore conclude that in order to achieve a better view of the operative field the serratus muscle may be dissected close to the origin if it is then readapt ed.