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Eur J Cardiothorac Surg 2000;18:435-439
© 2000 Elsevier Science NL

A comparative evaluation of intrathoracic latissimus dorsi and serratus anterior muscle transposition

^a Department of Thoracic and Cardiovascular Surgery, University of Berne, Berne, Switzerland
^b Department of Surgery, University of Lausanne, 1011 Lausanne, Switzerland
^c Division of Plastic and Reconstructive Surgery, University of Berne, Berne, Switzerland

Received 11 October 1999; received in revised form 20 June 2000; accepted 12 July 2000.

Corresponding author. Tel.: +41-21-314-2408; fax: +41-21-314-2358
e-mail: thorsten.krueger{at}chuv.hospvd.ch

Background: Comparison of intrathoracic latissimus dorsi (LD) versus serratus anterior (SA) muscle transposition for treatment of infected spaces, broncho-pleural fistulae, and for prophylactic reinforcement of the mediastinum after extended resections following induction therapy. Patients and methods: Twenty LD and 17 SA transfers were performed for prophylactic reinforcement (11 LD; nine SA), and treatment of infections (nine LD; eight SA) from 1995 to 1998. Results: The 30-day mortality was 0% following prophylactic reinforcement and 29% following treatment of infections (three LD; two SA). Prophylactic mediastinal reinforcement was successful in 11 of 11 patients with LD and nine of nine with SA transpositions, and treatment of infected spaces in eight of nine patients with LD and two of three with SA transfers. Morbidity requiring re-intervention consisted of flap necrosis (one LD), bleeding (one SA), and skin necrosis over a winged scapula (one SA). Subcutaneous seromas and chest wall complaints were more frequent following LD (45 and 36%, respectively) compared with SA transfers (29 and 27%, respectively), whereas impaired shoulder girdle function was more frequent after SA than after LD transfer (27 vs. 21%). Conclusion: Intrathoracic LD and SA muscle transpositions are both efficient for the prevention or control of infections following complex thoracic surgery, and are both associated with similar and acceptable morbidity and long-term sequelae.

Key Words: Intrathoracic muscle transposition • Latissimus dorsi muscle • Serratus anterior muscle

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