Mean change in FEV1 by comparing Postero-Lateral Thoracotomy versus Muscle Sparing Thoracotomy

Abstract

Objective:  To compare mean change in forced expiratory volume FEV1 before and after muscle sparing mid axillary vertical thoracotomy and postero lateral thoracotomy in patients of clotted hemothorax.Place and Duration: Department of Thoracic Surgery Postgraduate Medical Institute, Govt. Lady Reading Hospital Peshawar fromFeb. 2014 to Feb. 2015Material and Methods:  All patients presenting with clotted hemothorax were admitted through OPD and ER department and were subjected to detailed history and clinical examination and routine pre operative investigations. Preoperatively spirometry was done in all patients to record base line FEV1. All patients were randomly allocated in two groups by lottery method. Patients in group A were subjected to muscle sparing mid axillary vertical thoracotomy and patients in group B were subjected to posterolateral thoracotomy. All patients were followed up at 14 post operative day and spirometry was done to record post operative FEV . All the data were stored and analyzed in SPSS version 14.Results:  A total of 216 patients were observed, which were divided in two equal groups i.e Group A (MST) and Group B (PLT). Average pre operative FEV1 in postero lateral thoracotomy was 2.79+0.72SD while in muscle sparing mid axillary vertical thoracotomy group average FEV1 was 2.88+0.82SD which was insignificant with p value=0.405. Similarly when compared FEV1 after 14th post operative day the average FEV1 in potero lateral thoracotomy was 2.677+0.78SD while in muscle sparing mid axillary vertical group FEV1 was 2.76+0.81SD which shows also insignificance with p- value=0.405.Conclusion:  The exposure is adequate in both methods without favoring the one over the other concerning postoperative pulmonary function.