The lateral limited thoracotomy incision: standard for pulmonary operations.

The limited incision is a lateral muscle-splitting incision with preservation of the latissimus dorsi, splitting of the serratus anterior, and cutting of only the intercostal muscles without rib resection. Surgical procedures included lobectomy (n=317), pneumonectomy (n=41), wedge resection (n=82), resections of blebs or bullae (n=17), thoracotomy and biopsy for unresectable lesion (n=6), and decortication (n=5). Pathologic analysis revealed 354 malignant tumors, 102 benign lesions, and 12 carcinoids. The perioperative mortality rate was 0.85% (4/468) and major morbidity was present in 2.9% (14/468). Mean operative time was 73.1 (±32.2) minutes with a blood loss resulting in a mean decrease of the hematocrit value of 2.6 (±2.5) gm; three patients were given a total of 7 units of blood. Most patients do not require a stay in the intensive care unit postoperatively (less than 10%). Hospital stay postoperatively was a mean of 6.1 (±2.9 days)