title: A meta-analysis comparing muscle-sparing and posterolateral thoracotomy.
abstract: We compared outcomes of posterolateral thoracotomy vs muscle-sparing thoracotomy after open thoracic operations. Twelve trials were included, comprising 571 patients in the muscle-sparing thoracotomy group and 512 patients in the posterolateral thoracotomy group. There was significantly improved shoulder internal rotation (weighted mean difference, -1.28; 95% confidence interval, -2.45 to -0.11; p = 0.03) and pain scores on day 7 (weighted mean difference, -0.76; 95% confidence interval, -1.26 to -0.27; p = 0.002) but higher seroma rates (odds ratio, 8.26; 95% confidence interval, 2.16 to 31.56; p = 0.002) in the muscle-sparing thoracotomy group compared with the posterolateral thoracotomy group. We advocate using muscle-sparing thoracotomy, especially on patients dependant on quicker recovery of shoulder function.
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom. Electronic address: mohsinuzzaman@yahoo.co.uk.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Uzzaman
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom.
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Robb
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom.
authors.forename: Peter C E
authors.initials: PC
authors.lastname: Mhandu
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom.
authors.forename: Habib
authors.initials: H
authors.lastname: Khan
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom.
authors.forename: Kamran
authors.initials: K
authors.lastname: Baig
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Chaubey
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Whitaker
mesh_terms: D006801:Humans; D018482:Muscle, Skeletal; D059351:Organ Sparing Treatments; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome