Complications after pectus excavatum repair using pectus bars in adolescents and adults: risk comparisons between age and technique groups†

Choi, Shu Chung; Park, Hyung Joo

doi:10.1093/icvts/ivx162

Cited by 14 publications

(10 citation statements)

References 23 publications

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“…In this study, we examined the risk of developing spontaneous pneumothorax in this group of patients. In the literature, most of the studies that have investigated the relationship between PE and pneumothorax include pneumothorax that develops as a complication of the pectus operations [14, 15]. The relationship between chest configurations and the development of primary spontaneous pneumothorax was investigated in a recent study published by Park et al In this study, it has been noted that patients with primary spontaneous pneumothorax had a different thoracic configuration.…”

Section: Discussionmentioning

confidence: 99%

Is Pectus Excavatum a Risk Factor for Spontaneous Pneumothorax? “Haller Index Measurements in Patients with Primary Spontaneous Pneumothorax”

Kılıçgün

Yakşi

Ünal

2019

Canadian Respiratory Journal

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Aim. In this study, we aimed to retrospectively investigate whether pectus excavatum (PE) is a risk factor for the development of primary spontaneous pneumothorax (PSP) and to determine its role in the etiology of the disease. Materials and Methods. Chest-computed tomography (CT) of the patients who were treated for spontaneous pneumothorax between January 2015 and December 2017 in our clinic was examined, and their Haller indices were measured (group I). The patients in the control group who underwent chest CT for other reasons during the same period and were in the same age with the group I were also included in the study (group II) Results. In group I, for patients with PE, the mean Haller index was 2.41, while it was 2.09 in the control group (group II). There was a significant difference between the two groups. Conclusions. PE deformities in the chest wall may predispose to the development of spontaneous pneumothorax, and PE may be among the etiologic factors of spontaneous pneumothorax. Therefore, there is a need for studies involving larger patient groups.

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Section: Discussionmentioning

confidence: 99%

Is Pectus Excavatum a Risk Factor for Spontaneous Pneumothorax? “Haller Index Measurements in Patients with Primary Spontaneous Pneumothorax”

Kılıçgün

Yakşi

Ünal

2019

Canadian Respiratory Journal

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“…Only a few patients reported a foreign body sensation, indicating that low-profile titanium plates with 1.5 mm material thickness produce excellent results. In contrast, sternum-supporting metal bars are often palpable through the skin and soft tissue and can cause friction in the tissue due to movements between the bar, ribs, and musculature; this can cause sudden pain, hematomas, fluid retention, and chronic inflammation (10).…”

Section: Discussionmentioning

confidence: 99%

“…The closed mobilization of the chest wall by internal pressure in the context of the MIRPE is expediently applied in the growth phase or as long as the chest wall is elastic enough but has a higher complication rate in fully formed adults (8)(9)(10). As elasticity decreases with age and also with the degree of asymmetry of the deformity, open surgical procedures allow more precise mobilization and reduction of the chest wall.…”

Section: Original Articlementioning

confidence: 99%

Elastic stable chest repair and its hybrid variants in 86 patients with pectus excavatum

et al. 2018

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Background: Complex and mature funnel chest deformities are traditionally managed with open surgical procedures. Elastic stable chest repair (ESCR) has been used successfully and safely for relapse corrections. Does pure plate osteosynthesis in ESCR allow comparable corrective potency and implant safety as hybrid methods with metal bars? Methods: Data from 86 patients with open funnel chest correction between 2011 and 2015 were analyzed in this retrospective study. Exclusion criteria included being under 12 years of age, and having a history of septic wound healing disorder or other malignant diseases. Main groups consisted of ESCR and hybrid techniques, subgroups were primary and recurrence correction. Correction results and follow-up examinations at six and 12 weeks and at 1 year were statistically analyzed. Results: A total of 38 ESCR and 48 hybrid methods were analyzed. Bar implantation was required in 77% (recurrence 34%) of patients. All patients received plates with different combinations e.g., longitudinalsternal, costosternal and costo-sterno-costal. In all groups, follow-up uptake showed a funnel chest correction result at the anatomical level with healthy values according to the Haller index (ESCR 4.36-2.84, hybrid 6.99-2.74, P<0.001). No material dislocations were observed in any subgroup. Conclusions: ESCR and hybrid techniques represent promising and safe therapeutic approaches.

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“…Після впровадження торакоскопічної візуалізації [13], із задовільними результатами щодо корекції деформації, продовжилися розробки в бік поліпшення відновлення та реабілітації пацієнтів після оперативного втручання, а також стабільності корекції. Фіксатор із двома загрудинними пластинами по краях, з'єднаними між собою поперечними планками, був застосований для зниження ризику міграції металоконструкції, ротації фіксатора [2]. Наш клінічний досвід передбачає виконання різних модифікацій операції за методикою Nuss без/з торакоскопічним контролем.…”

Section: оригінальні дослідження торакальна хірургіяunclassified

Evolution of methods of surgical correction of pectus excavatum in children: single center experience

Levytskyi

Pylypko

Godik

et al. 2021

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Pectus excavatum (PE) in children is the most common pathology among orthopedic diseases of the anterior chest wall. Today in the world the main direction of scientific research in the surgical correction of this pathology is safety during surgery for the patient and the introduction of minimally invasive techniques. Purpose – to conduct a comparative analysis of the results of thoracoplasty in children with PE using different surgical techniques to reduce trauma and duration of surgery and blood loss; to study the optimal correction results to accelerate psycho-physical adaptation after the Nuss procedure. Materials and methods. The treatment of 289 patients operated on for PE in the orthopedic and traumatology department of National Children’s Specialized Hospital «OKHMATDYT» were analyzed. According to the methods of thoracoplasty used, patients were divided into 3 groups. In the first group (n=112) PE correction was performed using Nuss operation with subxiphoid access and tactile control during the retrosternal bar placement; in the second group (n=79) Nuss procedure was performed under thoracoscopic control, where one retrosternal T-shaped bar with additional lateral stabilizer was implanted and fixed on the ribs with a resorbable suture or wire; in the third group (n=98) surgical treatment of PE was performed using the Nuss procedure under thoracoscopic control using a fixator consisting of two retrosternal bars-arches, which are interconnected by lateral bars, the «Bridge» technique. Results. When using thoracoscopic control and temporary sternum elevation by modificated «Park crane» during the correction of PE, the time of surgery and blood loss was reduced. No rotations of the fixator throughout the observation period and lower postoperative pain syndrome were observed in patients of the 3rd group, who underwent corrections with the «Bridge technique». Conclusions. The technique of minimally invasive correction of pectus excavatum (MIRPE), Nuss operation, using thoracoscopic control and temporary elevation of the sternum during pectus bar placement is a safe and effective method of thoracoplasty. The use of two plates (the «Bridge» system) during minimally invasive correction is the operation of choice for adolescent children with funnel chest deformities. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: pectus excavatum; chest deformity; Nuss operation, surgery, pediatrics, thoracoplasty, results.

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Complications after pectus excavatum repair using pectus bars in adolescents and adults: risk comparisons between age and technique groups†

Abstract: Older patients have more asymmetric pectus deformity and they are also risk factors for complications following PE repair. The bridge technique provides a bar dislocation rate of 0%, even in adult patients. This procedure seems to reduce or prevent major complications following PE repair.

Cited by 14 publications

References 23 publications

Is Pectus Excavatum a Risk Factor for Spontaneous Pneumothorax? “Haller Index Measurements in Patients with Primary Spontaneous Pneumothorax”

Is Pectus Excavatum a Risk Factor for Spontaneous Pneumothorax? “Haller Index Measurements in Patients with Primary Spontaneous Pneumothorax”

Elastic stable chest repair and its hybrid variants in 86 patients with pectus excavatum

Evolution of methods of surgical correction of pectus excavatum in children: single center experience

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