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Muscle sparing thoracotomy for esophageal cancer: a comparison with posterolateral thoracotomy

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Purpose

The aim of this study was to investigate whether muscle sparing thoracotomy (MST) improved postoperative chest pain and an impairment of the postoperative pulmonary function in comparison with posterolateral thoracotomy (PLT).

Methods

Twenty-four patients with esophageal cancer who underwent PLT from September 2006 to August 2008 and 30 patients who underwent MST from September 2008 to August 2010 were selected as subjects of this study. Postoperative acute and chronic chest pain and the recovery of the pulmonary function were retrospectively compared between the two groups.

Results

The frequency of the additional use of analgesics was on days 3, 6, and 7 (mean 0.4 vs. 1.2, p = 0.027, 0.4 vs. 1.5, p = 0.007, and 0.2 vs. 1.2, p = 0.009, respectively) in the early postoperative period. The number of patients requiring analgesics at 1 and 3 months after surgery was significantly lower in the MST group than in the PLT group (13.3 vs. 58.3 %, p = 0.002, 10.0 vs. 50.0 %, p = 0.001, respectively). The postoperative vital capacity, expressed as a percentage of the preoperative value, 3 and 12 months after surgery was significantly higher in the MST group than in the PLT group (86.0 vs. 73.8 %, p = 0.028, 93.2 vs. 76.9 %, p = 0.002, respectively).

Conclusion

Compared with PLT, MST might, therefore, reduce postoperative chest pain and offer a better recovery of pulmonary function in patients with esophageal cancer.

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Acknowledgments

We are very grateful to Dr. Masayuki Shinoda of Aichi Cancer Center Hospital for teaching us how to perform MST.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Kazushi Miyata, Masahide Fukaya, Keita Itatsu, Tetsuya Abe & Masato Nagino

Authors
  1. Kazushi Miyata
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  2. Masahide Fukaya
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  3. Keita Itatsu
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  4. Tetsuya Abe
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  5. Masato Nagino
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Corresponding author

Correspondence to Masahide Fukaya.

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Conflict of interest

Kazushi Miyata and the other co-authors have no conflicts of interest to declare.

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Miyata, K., Fukaya, M., Itatsu, K. et al. Muscle sparing thoracotomy for esophageal cancer: a comparison with posterolateral thoracotomy. Surg Today 46, 807–814 (2016). https://doi.org/10.1007/s00595-015-1240-1

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  • DOI: https://doi.org/10.1007/s00595-015-1240-1

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