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Ann Thorac Surg 1986;41:130-134
© 1986 The Society of Thoracic Surgeons

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Articles

Median Sternotomy as a Standard Approach for Pulmonary Resection

Department of Thoracic and Cardiovascular Surgery, Baylor University Medical Center, Dallas, TX

^* Address reprint requests to Dr. Urschel, 1201 Barnett Tower, 3600 Gaston Ave, Dallas, TX 75246

	Abstract

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Pulmonary resection was performed electively through a median sternotomy in 174 patients. The first 61 of these patients were compared with an equal number having pulmonary resection through a lateral thoracotomy. Both groups were similar in regard to sex, age, pathological condition, and type of resection. The patients undergoing median sternotomy had a shorter operative time and less postoperative pain, and were discharged from the hospital sooner than the patients having resection through a lateral thoracotomy. The cardinal technical essentials to expeditious pulmonary resection through a median sternotomy involve unilateral pulmonary ventilation with a double-lumen endotracheal tube, arterial pressure and gas monitoring, and proper lung packing and retraction. Two patients died, 1 of infection and 1 of bleeding; neither death was related to the incision. Certain pulmonary procedures are better performed through a lateral thoracotomy, and these include resection of a superior sulcus carcinoma, pulmonary resection with posterior chest wall extension, and left lower lobe resection in patients who demonstrate obesity, cardiomegaly, or an elevated diaphragm.

	Footnotes

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Presented at the Twenty-first Annual Meeting of The Society of Thoracic Surgeons, Phoenix, AZ, Jan 21–23, 1985.

	References

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