Experience with modified posterolateral muscle-sparing thoracotomy in neonates, infants, and children.

Between May 1991 and December 1995, a total of 38 posterolateral muscle-sparing thoracotomies were performed in neonates and children. The technique described preserves the serratus anterior and most of the latissimus dorsi muscle. In all except 1 case, excellent exposure of the thoracic cavity was achieved. The muscle-sparing approach is easy to perform with appropriate attention to the anatomy of the chest wall. It has the advantages of minimal anatomic disturbance and trauma to the major chest-wall muscles, and hence is likely to be associated with less postoperative pain and, possibly, improved pulmonary function. A plea for routine use of a muscle-sparing incision for thoracotomy procedures in the pediatric age group is thus justifiable.