Pulmonary Function Before Surgery for Pectus Excavatum and at Long-term Follow-up

Morshuis, Wim J.; Folgering, H.T.M.; Barentsz, Jelle O.; Lier, H. van; Lk, Lacquet

doi:10.1378/chest.105.6.1646

Cited by 94 publications

(43 citation statements)

References 20 publications

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“…(18)(19)(20)(21) In conclusion, the present study is unique in the literature in that it determined the prevalence of congenital anterior chest wall deformities among students in the city of Manaus, Brazil. This prevalence was found to be 1.95%.…”

Section: Discussionmentioning

confidence: 85%

Prevalência de pectus carinatum e pectus excavatum em escolares de Manaus

et al. 2009

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OBJETIVO: Determinar a prevalência das deformidades congênitas da parede torácica anterior em escolares de 11 a 14 anos. MÉTODOS: Participaram do estudo escolares da rede estadual de ensino da cidade de Manaus (AM). Para a composição de uma amostra estatisticamente significativa, com precisão de 1% e IC95%, foram incluídos 1.332 escolares. A deformidade pectus foi identificada através de exame físico do tórax, e os indivíduos com esta deformidade responderam a um questionário com questões sobre hereditariedade e sintomatologia decorrente da anomalia torácica. RESULTADOS: A idade média dos participantes foi de 11,7 anos. A prevalência da deformidade pectus foi de 1,95% (pectus excavatum: 1,275%; pectus carinatum: 0,675%). Dos 26 escolares com deformidades pectus, 17 (65,4%) tinham pectus excavatum, e 18 (69,2%) eram do sexo masculino. Houve associação com a escoliose em 3 casos (11,5%). História familiar de pectus foi relatada por 17 escolares (65,4%), e 17 (65,4%) relataram dor torácica, dispneia ou palpitações. CONCLUSÕES: A prevalência das deformidades pectus encontrada neste estudo (1,95%) foi inferior àquela de trabalhos em outras regiões do país (3,6-4,9%), porém, superior àquela relatada na literatura (média, 1%).

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Section: Discussionmentioning

confidence: 85%

Prevalência de pectus carinatum e pectus excavatum em escolares de Manaus

et al. 2009

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“…In other CDH patients with pectus excavatum, a reduced lung function compared to normal CDH patients has been demonstrated [70,145]. It is, however, controversial whether a Nuss procedure results in an improvement in pulmonary function [145][146][147].…”

Section: Chest Wall Deformitiesmentioning

confidence: 99%

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

et al. 2008

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Congenital diaphragmatic hernia (CDH) is a life-threatening anomaly with a mortality rate of approximately 40-50%, depending on case selection. It has been suggested that new therapeutic modalities such as nitric oxide (NO), high frequency oxygenation (HFO) and extracorporal membrane oxygenation (ECMO) might decrease mortality associated with pulmonary hypertension and the sequelae of artificial ventilation. When these new therapies indeed prove to be beneficial, a larger number of children with severe forms of CDH might survive, resulting in an increase of CDH-associated complications and/or consequences. In follow-up studies of infants born with CDH, many complications including pulmonary damage, cardiovascular disease, gastro-intestinal disease, failure to thrive, neurocognitive defects and musculoskeletal abnormalities have been described. Long-term pulmonary morbidity in CDH consists of obstructive and restrictive lung function impairments due to altered lung structure and prolonged ventilatory support. CDH has also been associated with persistent pulmonary vascular abnormalities, resulting in pulmonary hypertension in the neonatal period.

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“…Patients unfit for surgery or with diseases that would increase morbidity of the surgical procedure were excluded. The age of the patients in the control group ranged from 16 to 35 years (mean, 25.8 years), 6 were male, and all were White. Patients with diseases that might interfere with the morphology of the thoracic cage were also excluded.…”

Section: Methodsmentioning

confidence: 99%

“…In more severe cases, there is considerable dislocation of the heart upwards and to the left, with significant reduction in chest volume. Despite the deformity, most heart and pulmonary function tests are normal, or there is only a discrete reduction in the total lung capacity and inspiratory vital capacity (6) . In view of this, various studies have dealt with functional results in preoperative and postoperative PEX, and there is consensus that there are no significant measurable changes in cardiorespiratory function, although there is subjective improvement, especially an increase in exercise tolerance (7) .…”

Section: Introductionmentioning

confidence: 99%

Índice antropométrico para classificação quantitativa do pectus excavatum

Rebeis¹,

Samano²,

Dias³

et al. 2004

J. bras. pneumol.

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Background: Pectus excavatum is characterized by concave growth of costal cartilage and depression of the lower sternum. Clinical means of classifying these malformations are few and difficult to apply. Objective:To devise clinical tools for quantifying the deformity and comparing preoperative and postoperative findings.Method: A total of 10 pectus excavatum patients who underwent surgery in which the modified Robicsek technique was used by the Thoracic Surgery Group of the Hospital das Clínicas of the University of São Paulo School of Medicine, were clinically and radiologically evaluated in the preoperative and postoperative periods. Ten control individuals, presenting no thoracic or radiological abnormalities, were submitted to identical evaluations. Deformities at the sternum notch level and at the point of maximum deformity were assessed using the anthropometric index and the Haller index.Results: Multivariate analysis of anthropometric index means revealed significant differences between preoperative and control values and between preoperative and postoperative values, as well as a nonsignificant difference between postoperative and control values. The same results were obtained when Haller index means were analyzed. A paired comparison of preoperative and postoperative means showed two distinct groups. An 86% canonical correlation was found between the anthropometric index and the Haller index. Conclusion:Patients with pectus excavatum can be quantitatively assessed in the preoperative and postoperative periods through the use of the anthropometric index, which allows objective, comparative evaluation of the results and is easily performed.

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Pulmonary Function Before Surgery for Pectus Excavatum and at Long-term Follow-up

Cited by 94 publications

References 20 publications

Prevalência de pectus carinatum e pectus excavatum em escolares de Manaus

Prevalência de pectus carinatum e pectus excavatum em escolares de Manaus

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

Índice antropométrico para classificação quantitativa do pectus excavatum

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