Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Mar;12(3):1031-1040.
doi: 10.21037/jtd.2019.12.93.

Assessment of chest wall movement following thoracotomy: a systematic review

Karina Tukanova  1 , Enrica Papi  1   2 , Sara Jamel  1 , George B Hanna  1 , Alison H McGregor  1 , Sheraz R Markar  1
Affiliations
Review

Assessment of chest wall movement following thoracotomy: a systematic review

Karina Tukanova et al. J Thorac Dis. 2020 Mar.

Abstract

Thoracotomy is a major cause of respiratory impairment, increasing the risk of postoperative pulmonary complications (PPC). Systems assessing ribcage kinematics may detect changes in chest expansion following thoracotomy and may thus aid in the development of patient-tailored chest physiotherapy. Hence, we aimed to identify studies assessing changes in chest wall movement following thoracotomy using objective measures. The Cochrane library, MEDLINE, EMBASE, Scopus and Web of Science databases were searched to find relevant articles providing an objective assessment of chest wall movement following thoracotomy. Methodological quality of included studies concerning chest wall movement following thoracotomy was assessed by use of QUADAS-2 tool. A total of 12 articles were included for the assessment of chest wall changes following thoracotomy using objective measures. Four studies measured changes in the cross-sectional area of the ribcage and abdomen using the respiratory inductive plethysmography (RIP), 1 study computed the chest wall compliance by monitoring the intra-pleural pressure, 3 studies measured changes in chest circumference with a simple tape measure and 4 articles performed a compartmental analysis of the chest wall volume by means of an optoelectronic plethysmography (OEP). There was no delay in the collection of data of the index test and reference standard, resulting in a low risk of bias for the flow and timing domain. Across all studies, participants underwent the same reference standard, resulting in a low risk of verification bias. Several objective measures were able to detect changes in chest wall displacement following thoracotomy and differed in the practical use and invasive nature. OEP allows a compartmental analysis of the chest wall volume. Hence, this system allows to assess chest wall movement changes following thoracotomy and the impact of different types of surgical approach. Furthermore, it could aid in the development of tailored physiotherapy.

Keywords: Chest wall motion; esophagectomy; respiratory mechanics; respiratory pattern; thoracotomy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the study selection process.
Figure 2
Figure 2
Tabular presentation of the QUADAS-2 assessment for each study.
Figure 3
Figure 3
Graphical summary of the QUADAS-2 results.
See this image and copyright information in PMC

References

    1. Van Schil PE, Balduyck B, De Waele M, et al. Surgical treatment of early-stage non-small-cell lung cancer. EJC Suppl 2013;11:110-22. 10.1016/j.ejcsup.2013.07.021 - DOI - PMC - PubMed
    1. Ando N, Ozawa S, Kitagawa Y, et al. Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg 2000;232:225-32. 10.1097/00000658-200008000-00013 - DOI - PMC - PubMed
    1. Khan IH, McManus KG, McCraith A, et al. Muscle sparing thoracotomy: a biomechanical analysis confirms preservation of muscle strength but no improvement in wound discomfort. Eur J Cardiothorac Surg 2000;18:656-61. 10.1016/S1010-7940(00)00591-1 - DOI - PubMed
    1. Nakata M, Saeki H, Yokoyama N, et al. Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg 2000;70:938-41. 10.1016/S0003-4975(00)01513-7 - DOI - PubMed
    1. Lanza Fde C, de Camargo AA, Archija LR, et al. Chest wall mobility is related to respiratory muscle strength and lung volumes in healthy subjects. Respir Care 2013;58:2107-12. 10.4187/respcare.02415 - DOI - PubMed