Thorac Cardiovasc Surg 2010; 58(5): 295-298
DOI: 10.1055/s-0030-1249829
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Isokinetic Muscle Strength after Thoracotomy: Standard vs. Muscle-Sparing Posterolateral Thoracotomy

S. Ziyade1 , A. Baskent2 , S. Tanju1 , A. Toker1 , S. Dilege1
  • 1Department of Thoracic Surgery, Istanbul Universty Istanbul Medical School, Istanbul, Turkey
  • 2Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Medical School, Istanbul, Turkey
Further Information

Publication History

received Dec. 1, 2009

Publication Date:
02 August 2010 (online)

Abstract

Background: The aim of the study was to compare the effects of conventional posterolateral thoracotomy and muscle-sparing posterolateral thoracotomy on pulmonary and muscle strength. Methods: From January 2003 to December 2004, 50 randomized patients with a diagnosis of primary lung cancer underwent pulmonary resection. The patients were divided into two groups: Group I (n = 25) underwent conventional posterolateral thoracotomy, while Group II (n = 25) had muscle-sparing thoracotomy. The groups were compared in terms of shoulder abduction/adduction isokinetic muscle strength and respiratory muscle strength. Results: A comparison of maximal expiratory pressure and maximal inspiratory pressure preoperatively and postoperatively and of maximal expiratory pressure and maximal inspiratory pressure preoperatively and at 3 months postoperatively showed statistically significant differences (p < 0.05). Conclusion: For the preservation of muscle strength, especially in patients whose jobs involved manual work, muscle-sparing posterolateral thoracotomy should be the first choice rather than conventional thoracotomy. Moreover, if necessary, the latissimus dorsi muscle can be used more extensively as a flap after muscle-sparing posterolateral thoracotomy procedures.

References

  • 1 Hazelrigg S R, Landreneau R J, Boley T M et al. The effect of muscle-sparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain.  J Thorac Cardiovasc Surg. 1991;  101 394-401
  • 2 Murthy S C, Rice T W. Thoracic incisions. Pearson FG, Cooper JD, Deslauriers J, Ginsberg JR, Hiebert C, Patterson GA, Urschel HC Thoracic surgery. 2nd ed. New York; Churchill Livingstone 2002: 120-139
  • 3 Dvir Z. Isokinetics. Hardware, test parameters, and issues in testing. Dvir Z Muscle testing, interpretation and clinical applications. 2nd ed. New York; Churchill Livingstone 1995: 1-79
  • 4 Perrin H D. Isokinetic instrumentation. Perrin HD Isokinetic exercise and assessment. West Yorkshire; Human Kinetics Publishers 1993: 1-212
  • 5 Basyigit I. Spirometrik inceleme. Ilgazlı A, Cağlar T Solunum Fonksiyon Testleri ve Klinik Kullanımları. Istanbul; Nobel Tıp Kitapevleri 2004: 31-51
  • 6 Nomori H, Horio H, Iga R, Shouyama Y, Kobayashi R. Postoperative changes of maximum inspiratory and expiratory pressures in 3 pneumonia cases occurring after surgery for empyema.  Kyobu Geka. 1996;  6 445-448
  • 7 Nomori H, Kobayashi R, Fuyuno G, Morinaga S, Yashima H. Preoperative respiratory muscle training. Assessment in thoracic surgery patients with special reference to postoperative pulmonary complications.  Chest. 1994;  6 1782-1788
  • 8 Furrer M, Rechsteiner R, Eigenmann V, Signer C, Althaus U, Ris H B. Thoracotomy and thoracoscopy: postoperative pulmonary function, pain and chest wall complaints.  Eur J Cardiothorac Surg. 1997;  12 82-87
  • 9 Nakata M, Saeki H, Yokoyama N, Kurita A, Takiyama W, Takashima S. Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy.  Ann Thorac Surg. 2000;  70 938-941
  • 10 Mayer F, Horstmann T, Rocker K, Heitkamp H C, Dickhuth H H. Normal values of isokinetic maximum strength, the strength/velocity curve, and the angle at peak torque of all degrees of freedom in the shoulder.  Int J Sports Med. 1994;  15 19-25
  • 11 Akçalı Y, Demir H, Tezcan B. The effect of standard posterolateral versus muscle-sparing thoracotomy on multiple parameters.  Ann Thorac Surg. 2003;  76 1050-1054
  • 12 Van Meeteren J, Roebroek M E, Stam H J. Test-retest reliability in isokinetic muscle strength measurements of the shoulder.  J Rehabil Med. 2002;  34 91-95
  • 13 Mayer F, Horstmann T, Kranenberg U, Rocker K, Dickhuth H H. Reproducibility of isokinetic peak torque and angle at peak torque in the shoulder joint.  Int J Sports Med. 1994;  15 26-31
  • 14 Kutlu C A, Akin H, Olcmen A, Biliciler U, Kayserilioğlu A, Ocmen M. Shoulder-girdle strength after standard and lateral muscle-sparing thoracotomy.  Thorac Cardiov Surg. 2001;  49 112-114
  • 15 Khan I F, McManus K G, McCraith A, McGuigan J A. Muscle-sparing thoracotomy: a biomechanical analysis confirms preservation of muscle strength but no improvement in wound discomfort.  Eur J Cardiothorac Surg. 2000;  18 656-661

Dr. Serhan Tanju

Department of Thoracic Surgery
Istanbul Universty Istanbul Medical School
Capa

Millet St

34390 Istanbul

Turkey

Email: drstanju@hotmail.com

    >