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

Matthias Kurt Widmer, Thorsten Krueger, Didier Lardinois, Andrej Banic, Hans Beat Ris
Comparison of intrathoracic latissimus dorsi (LD) versus serratus anterior (SA) muscle transposition for treatment of infected spaces, broncho-pleural ®stulae, 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
more » ... y 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¯ap 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 ef®cient for the prevention or control of infections following complex thoracic surgery, and are both associated with similar and acceptable morbidity and long-term sequelae. q
doi:10.7892/boris.114998 fatcat:bnup2t5dmndbjnhtg5alvjbfhi