Study objective: We developed anterior limited
thoracotomy (ALT) with intrathoracic illumination for curative
resection of lung cancer. The present study evaluated the benefits of
ALT by retrospective comparison with anteroaxillary thoracotomy (AAT)
and posterolateral thoracotomy (PLT).
cancer patients, who underwent lobectomy via ALT (n = 28), AAT
(n = 28), and PLT (n = 28), were matched by gender and age.
Operating time, blood loss during operation, chest tube drainage volume
24 h after surgery, chest tube drainage duration, and vital
capacity (VC) and chest pain from early to late postoperative period
were studied for ALT, AAT, and PLT. Early postoperative chest pain was
evaluated by a visual analog scale and analgesic requirements, and
chronic pain was divided into five grades.
difference was observed in operating time among ALT, AAT, and PLT. ALT
has the following advantages over PLT: (1) less blood loss during
surgery (p < 0.05); (2) reduced postoperative drainage volume
(p < 0.05) resulting in shorter chest tube drainage (p < 0.001);
(3) diminished impairment of VC for 1 week to 6 months after surgery
(p < 0.01 or p < 0.001); and (4) reduced pain from 1 day and 6
months after surgery (p < 0.001). ALT also has the advantage over
AAT in reduced pain 5 days (p < 0.01) and 7 days (p < 0.05) after
surgery and in decreased analgesic requirements during 14 days after
surgery (p < 0.05).
Conclusion: ALT is a sufficient
and minimally invasive thoracotomy alternative to PLT or AAT for
curative lung cancer resection.
AAT = anteroaxillary thoracotomy; ALT = anterior limited
thoracotomy; FFL = flexible fiber light; MST = muscle-sparing
thoracotomy; PLT = posterolateral thoracotomy; POD = postoperative
day; VATS = video-assisted thoracoscopic surgery; VC = vital