HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Anthony P.C. Yim Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Li, W. W.L. Articles by Yim, A. P.C. Search for Related Content PubMed PubMed Citation Articles by Li, W. W.L. Articles by Yim, A. P.C. Related Collections Chest wall Lung - cancer Minimally invasive surgery

Eur J Cardiothorac Surg 2003;23:390-396
© 2003 Elsevier Science NL

The impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy

^a Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
^b Department of Physiotherapy, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China

Received 15 August 2002; received in revised form 22 November 2002; accepted 25 November 2002.

^* Corresponding author. Tel.: +86-852-2632-2629; fax: +86-852-2647-8273
e-mail: yimap{at}cuhk.edu.hk

Objective: Whether video-assisted thoracic surgery (VATS) is associated with less shoulder dysfunction when compared with posterolateral thoracotomy (PLT) remains unclear. We therefore conducted this prospective study to assess the shoulder function in patients following major lung resection using either the VATS or PLT approach. Methods: Twenty-nine consecutive patients were prospectively recruited into the study. Eighteen patients underwent major lung resection through VATS (VATS group) and 11 patients through PLT (open group). Shoulder function was measured preoperatively, and postoperatively at 1 week, 1 month and at 3 months. All assessments were done by two experienced physiotherapists using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form. Results: Shoulder strength was significantly better preserved in the VATS group at 1 week after surgery when compared with the PLT group (92 versus 81% of preoperative value; P=0.024). VATS patients also had better range of motion especially with respect to external rotation at 1 week (98 versus 91%; P=0.015) and forward elevation at 1 month (98 versus 93%; P=0.024) and 3 months after surgery (100 versus 96%; P=0.021). Analgesic requirement was significantly less in the VATS group postoperatively at 1 week (P=0.009) and 1 month (P=0.004). Conclusions: VATS major lung resection is associated with significantly less shoulder dysfunction and pain medication requirement in the early postoperative period when compared to the PLT approach.

Key Words: Video-assisted thoracic surgery • Thoracotomy • Shoulder function

This article has been cited by other articles:

				K. Nakanishi Video-Assisted Thoracic Surgery Lobectomy With Bronchoplasty for Lung Cancer: Initial Experience and Techniques Ann. Thorac. Surg., July 1, 2007; 84(1): 191 - 195. [Abstract] [Full Text] [PDF]

				C. S.H. Ng, S. Wan, C. W.C. Hui, I. Y.P. Wan, T. W. Lee, M. J. Underwood, and A. P.C. Yim Video-assisted thoracic surgery lobectomy for lung cancer is associated with less immunochemokine disturbances than thoracotomy Eur. J. Cardiothorac. Surg., January 1, 2007; 31(1): 83 - 87. [Abstract] [Full Text] [PDF]

				F. H.F. Tsang, S.-S. Chung, and A. D.L. Sihoe Video-assisted thoracic surgery for bronchopulmonary sequestration Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 424 - 426. [Abstract] [Full Text] [PDF]

				C S H Ng, T W Lee, S Wan, and A P C Yim Video assisted thoracic surgery in the management of spontaneous pneumothorax: the current status. Postgrad. Med. J., March 1, 2006; 82(965): 179 - 185. [Abstract] [Full Text] [PDF]

				R. J. McKenna Jr, W. Houck, and C. B. Fuller Video-Assisted Thoracic Surgery Lobectomy: Experience With 1,100 Cases Ann. Thorac. Surg., February 1, 2006; 81(2): 421 - 426. [Abstract] [Full Text] [PDF]

				J. D. Luketich, S. R. Land, E. A. Sullivan, M. Alvelo-Rivera, J. Ward, P. O. Buenaventura, R. J. Landreneau, L. A. Hart, and H. C. Fernando Thoracic Epidural Versus Intercostal Nerve Catheter Plus Patient-Controlled Analgesia: A Randomized Study Ann. Thorac. Surg., June 1, 2005; 79(6): 1845 - 1850. [Abstract] [Full Text] [PDF]

				M. I. Fernandez, A. E. Martin-Ucar, H.D. Lee, K. J. West, R. Wyatt, and D. A. Waller Does a thoracic epidural confer any additional benefit following video-assisted thoracoscopic pleurectomy for primary spontaneous pneumothorax? Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 671 - 674. [Abstract] [Full Text] [PDF]

				T. Ohtsuka, H. Nomori, H. Horio, T. Naruke, and K. Suemasu Is Major Pulmonary Resection by Video-Assisted Thoracic Surgery an Adequate Procedure in Clinical Stage I Lung Cancer? Chest, May 1, 2004; 125(5): 1742 - 1746. [Abstract] [Full Text] [PDF]

				C S H Ng, S Wan, A P C Yim, M Henry, T Arnold, and J Harvey Paradigm shift in surgical approaches to spontaneous pneumothorax: VATS Thorax, April 1, 2004; 59(4): 357 - 357. [Full Text] [PDF]