Intrathoracic transposition of the serratus anterior muscle flap--personal experience with 65 consecutive patients.


OBJECTIVE The objective of our article is to analyse the results of intrathoracic transposition of the serratus anterior (SA) muscle flap for suppurative diseases. METHOD We performed a retrospective analysis of 65 consecutive patients operated upon in our unit between 1 January 2003 and 1 March 2009 in whom we used intrathoracic transposition of the SA muscle flap. The flap was used alone or in association with other flaps and/or thoracoplasty in patients not amenable to lung resection and/or decortication, including tuberculous (TB) lesions in 30 patients (46%), postoperative empyema in 12 patients (18%), frank intrapleural rupture of a pulmonary cavity in 13 patients (20%) and bronchial fistula(e) in 26 patients (40%). Many patients presented a combination of the afore-mentioned anatomo-clinical characteristics. The SA was used alone in 16 patients (25%) and in combination with other flaps in 49 patients (75%). In most cases (62 patients, 95%), the flap was mobilised using both the thoracodorsal branch and the lateral thoracic vessels. Associated limited rib resection was performed with an average of 4.9±1.6 resected ribs per patient. RESULTS In general, mortality was 5% (three patients) and other two patients (3%) presented recurrence of the intrathoracic infection requiring re-operation; minor local complications were encountered in three patients (skin necrosis--two cases and external thoracic fistula--one case). Postoperative hospitalisation ranged between 4 and 172 days, with a median of 34 days. We encountered a mild impairment of shoulder mobility in five patients, but no case of true-winged scapula. Analysis of the pre- and postoperative values of the vital capacity (VC) and forced expiratory volume in 1s (FEV1) showed no statistically significant difference (paired t test -p>0.05). CONCLUSIONS The SA muscle flap is very well suited for intrathoracic transposition. Its use is not associated with significant postoperative morbidity.

DOI: 10.1016/j.ejcts.2010.04.039


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@article{Boianu2010IntrathoracicTO, title={Intrathoracic transposition of the serratus anterior muscle flap--personal experience with 65 consecutive patients.}, author={Petre Vlah-Horea Boţianu and Alexandru Mihail Botianu and Adrian Cristian Dobrica and Vladimir Constantin Bacarea}, journal={European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery}, year={2010}, volume={38 6}, pages={669-73} }