The influence of thoracotomy on the chest wall movement--difference between intercostal thoracotomy and median sternotomy
Sumitomo, S.
Nihon Kyobu Geka Gakkai 36(9): 1995-2004
1988
ISSN/ISBN: 0369-4739 PMID: 3204287 Document Number: 314331
The influence of thoracotomy on the chest wall movement was examined using a newly produced 6-channeled linear magnetometer that displays the deviatio of the chest wall during respiration. The maximal deviation of the chest wall from FRC to TLC was measured preoperatively and day 7, day 14, day 21, day 28, day 60, postoperatively in the intercostal thoracotomy group (ICT) and the median sternotomy group (MST). The intercostal thoracotomy group was divided into 2 subgroups: in one group, closure was performed by intercostal ligation, which caused intercostal neuralgia, and in the other, closure was performed by rib centysis, which caused no intercostal neuralgia. The decrease of the chest wall movement on postoperative day 7, was about 60% in the ICT group and 40% in the MST group compared with the preoperative movement. The postoperative pain in the ICT group was greater than that in the MCT group. The recovery from the decrease of the chest wall movement in the MST group was faster than that in the ICT grup. The recovery of the chest wall movement in the ICT subgroup with intercostal neuralgia was slower than that in the intercostal neuralgia free subgroup. This study suggests that medin sternotomy is safer and more useful than intercostal thoracotomy with respect to the protection of postoperative chest wall movement.