Median sternotomy as a standard approach for pulmonary resection.
Pulmonary resection was performed electively through a median sternotomy in 174 patients. The first 61 of these patients were compared with an equal number having pulmonary resection through a lateral thoracotomy. Both groups were similar in regard to sex, age, pathological condition, and type of resection. The patients undergoing median sternotomy had a shorter operative time and less postoperative pain, and were discharged from the hospital sooner than the patients having resection through a lateral thoracotomy. The cardinal technical essentials to expeditious pulmonary resection through a median sternotomy involve unilateral pulmonary ventilation with a double-lumen endotracheal tube, arterial pressure and gas monitoring, and proper lung packing and retraction. Two patients died, 1 of infection and 1 of bleeding; neither death was related to the incision. Certain pulmonary procedures are better performed through a lateral thoracotomy, and these include resection of a superior sulcus carcinoma, pulmonary resection with posterior chest wall extension, and left lower lobe resection in patients who demonstrate obesity, cardiomegaly, or an elevated diaphragm.
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay; D008168:Lung / Q000601:surgery*; D008171:Lung Diseases / Q000401:mortality / Q000601:surgery; D008297:Male; D008722:Methods; D008875:Middle Aged; D010146:Pain; D013249:Sternum / Q000601:surgery*; D013903:Thoracic Surgery; D013997:Time Factors