Muscle-sparing Thoracotomy

Surgical access to the thoracic cavity can be performed through a variety of approaches. Traditional surgical approaches focused on optimizing exposure, often times at the expense of sparing adjacent truncal muscles, such as the latissimus dorsi or serratus anterior, which can serve as lifeboats in thoracic reconstruction. Numerous studies have evaluated the differences in these techniques, focusing on surgical access, postoperative pain, shoulder strength and mobility, and lung function. We advocate, whenever possible, the routine use of a muscle-sparing thoracotomy to preserve vital local flap options for reconstruction of postresection complications. These flaps can assist in the management of postoperative wound healing complications, such as empyemas and bronchopleural fistulae. When local flap options are unavailable, other flap options are often more morbid and can be challenging. Herein, we describe the technique for a muscle-sparing thoracotomy at our institution.