Indications and Types of Thoracic Incisions in Al-Ramadi City


Background:Thoracotomy incision was done in Ramadi City and it is not uncommon surgical procedure.
Objectives: Descriptive study for the indications for thoracotomy and the type of surgical incision .
Materials &Methods:A descriptive study was carried out on 130 consecutive patients who underwent thoracotomy for a time period between June 2007-June 2010 the whole work was done in Ramadi Teaching Hospital and Private hospital.
Results:-The age of incidence was ranged from one day to seventy six years old. Male to female ratio was equal.
Thoracotomy indications in childhood age group were commonly due to congenital malformation (Tracheo-esophageal fistula, diaphragmatic hernia and cong. Lobar emphysema).
In adulthood :-Hydatid cysts of the lung, mixed H.C of the right lung and right liver lobe or H.C of the posterior segment of the liver had higher percentage of indications in addition to early stages of bronchogenic tumors if those cases detected early and they are fit for surgery .
Regarding the type of thoracotomy incision, postero-lateral thoracotomy at the fifth intercostal space without rib resection was the most popular type of incision. Median sternotomy was used for cardiac injury and thymectomy procedures.
Thoracotomy can be used in some cases of the H.C liver and (mixed H.C right lung and posterior segment of the right lobe of the liver)without the need for thoraco-abdominal incision.
Conclusions &Recommendations:Thoracotomy is not uncommon procedure in Al-Ramadi Teaching Hospital it is regularly done for both emergency and elective indications.
1-There are many types of thoracotomy incisions and the classical postero-lateral thoracotomy is the most common type. the procedure can be indicated in cases of emergency and elective manner, thoracic and extra-thoracic conditions.
2-Congenital malformations of the esophagus(T.E.F),diaphragmatic hernia and lobar emphysema are major indications of thoracotomy in childhood.
3-Hydatid cysts of the lungs, posterior liver and right lung or hydatid cyst of the posterior liver are common indications of thoracotomy in adult age group.
4-old age group can tolerate the procedure and good results can be obtained if careful patient selection and preparation.
Key words : Thoracotomy, Incisions ,Saad , Al-Anbar, Iraq .