Neonatal Thoracotomy Has 25% Chance of Chest Wall Deformity

One major argument for minimally invasive thoracic surgery is that open thoracotomies in neonates can lead to long-term chest wall deformities.

The actual incidence of chest wall deformities following neonatal thoracotomy has never really been shown prior to this study.

The study explored musculoskeletal deformities in patients who underwent open repair of esophageal atresia between 1997 and 2012 at Montreal Children's Hospital.

None of the patients in the study had any other predisposition to musculoskeletal deformities.

The study cohort consisted of 52 patients with a median follow-up of eight years.

Musculoskeletal deformities developed in 25% of patients following neonatal thoracotomy for esophageal atresia repair.

Non-muscle-sparing thoracotomy had a 55% chance of causing musculoskeletal deformity.

Muscle-sparing thoracotomy had a 16% chance of causing musculoskeletal deformity.

Division of the serratus anterior muscle was associated with significantly higher probability of developing musculoskeletal deformities even after adjusting for possible confounding variables.

A muscle-sparing technique decreases the incidence of musculoskeletal deformities following neonatal thoracotomy.

Minimally invasive thoracoscopic surgery probably also decreases the incidence of musculoskeletal deformities compared to open thoracotomy.