Thoracic Outlet Syndrome After the Nuss Procedure for the Correction of Extreme Pectus Excavatum

Lee, Seung Hwan; Ryu, Se Min; Cho, Seong Joon

doi:10.1016/j.athoracsur.2010.10.093

Cited by 17 publications

(10 citation statements)

References 8 publications

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“…There was a significant difference in the measurements between the one bar and the two bar group. And there is reported that after removing the uppermost metal bar to expand the possibly compressed the thoracic outlet, the rapid improvement in the vascular and neuronal symptoms [ 4 ]. This finding suggests that the uppermost bar could influence the costoclavicular measurements.…”

Section: Discussionmentioning

confidence: 99%

“…Several methods for the correction of pectus excavatum have been performed in the meantime, and the Nuss procedure has become the procedure of choice because of its less invasiveness and remarkable results [ 2 ]. Despite its remarkable results, several complications have been reported, including cardiopulmonary injury, pericardial and pleural effusion, wound infection, and bar migration [ 4 ]. Besides these complications, thoracic outlet syndrome (TOS) after the Nuss procedure was recently reported [ 4 ],[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Despite its remarkable results, several complications have been reported, including cardiopulmonary injury, pericardial and pleural effusion, wound infection, and bar migration [ 4 ]. Besides these complications, thoracic outlet syndrome (TOS) after the Nuss procedure was recently reported [ 4 ],[ 5 ]. TOS is a syndrome which occurs due to the compression of the neurovascular bundle which is composed of the brachial plexus, and the subclavian artery, or the subclavian vein [ 6 ]-[ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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A study about the costoclavicular space in patients with pectus excavatum

Kim

Park

et al. 2014

J Cardiothorac Surg

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BackgroundThe aim of the present study is to investigate the costoclavicular space in patients with pectus excavatum.Materials and methodsBetween April and November 2011, consecutive 50 patients with pectus excavatum and consecutive 50 patients without pectus excavatum were included into the present study. The costoclavicular measurements (the shortest distance, the crossing angle) were measured for the costoclavicular investigation.ResultsFirstly, there were no significant differences of the costoclavicular measurements in each and between symmetric and asymmetric subgroup, and in the overall, bilaterally. The shortest distance had a significant positive correlation with BMI (right p = 0.001, left p = 0.032) and a significant negative correlation with the crossing angle (right p = 0.013, left p = 0.001). Secondly, in the control group, the shortest distance had significant positive correlations with body weight and BMI (Body weight right p = 0.001, left p < 0.001; BMI right p = 0.001, left p < 0.001), and significant negative correlations with the crossing angles (right p = 0.002, left p < 0.001) and the sternal angle (right p = 0.032, left p = 0.017). Thirdly, the control group had the significant longer shortest distance than the pectus excavatum group (right p <0.001, left p <0.001). Fourthly, a decrease of the shortest distance (right p <0.001, left p <0.001), an increase of the crossing angle (right p < 0.001, left p < 0.001) and the sternal angle (p <0.001), and also a decrease of the Haller index (p <0.001) was found postoperatively.ConclusionPatients with pectus excavatum originally have narrower costoclavicular spaces than the normal control group, and the postoperative costoclavicular space are much narrower also.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0189-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A study about the costoclavicular space in patients with pectus excavatum

Kim

Park

et al. 2014

J Cardiothorac Surg

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“…3) In 2011, Lee, et al reported a rare case of a complicated thoracic outlet syndrome after a modified Nuss procedure. 4) Nevertheless, CRPS following the Nuss procedure for correction of pectus excavatum has not been reported.…”

Section: Discussionmentioning

confidence: 99%

“…2) Neurologic complications have been reported only rarely. 3,4) We described an adult patient who had type I complex regional pain syndrome (CRPS I) that developed after the Nuss procedure.…”

Section: Introductionmentioning

confidence: 99%

Complex Regional Pain Syndrome Following the Nuss Procedure for Severe Pectus Excavatum

Chen

Cheng

2014

ATCS

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Complex regional pain syndrome (CRPS) is not an uncommon complication after surgery, but has never been reported after the Nuss procedure for repairing pectus excavatum. A 22-year-old man with pectus excavatum had type I CRPS that developed 2 weeks after the Nuss procedure. He complained of persistent pain, hyperalgesia, weakness, edema, and color and temperature changes on right upper extremity. Following intensive rehabilitation, the degree of pain, weakness and edema were ameliorated. He recovered 6 months after surgery and the pectus bars were removed uneventfully 3 years after the repair.

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Post‐operative arrest following pectus excavatum repair: A case report with a systematic review of the published case reports

Roostaei,

Amini,

Abtahi

et al. 2024

Clinical Case Reports

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Key Clinical MessageCommon complications after PE surgery include ventricular tachycardia, cardiac arrest, pneumothorax, and bar displacement. These can lead to severe outcomes, emphasizing the need for caution and meticulous post‐operative monitoring. Patients and their families should be well‐informed about potential risks during the consent process.AbstractThe objective of this study was to raise awareness among medical staff and surgeons about potential complications, particularly rare and life‐threatening ones, associated with pectus excavatum (PE) surgery. PE is the most common chest wall deformity, characterized by sternal depression. Patients primarily seek treatment for cosmetic concerns, but some also report exercise intolerance and shortness of breath. Although surgical repair is the standard treatment, the incidence and nature of severe complications remain unclear and underreported. This study presents a case of a lethal cardiac event following PE surgery and conducts a systematic review of published case reports. This study describes a case of a lethal complication of ventricular fibrillation and cardiac arrest following the Ravitch procedure for correction of PE in a 10‐year‐old boy. A systematic review of relevant cases of PE surgery complications was conducted. Of the 506 initial records retrieved, 93 case reports from 83 articles were identified over the 23 years. Among them, 72 patients were male, and 20 cases were female. The average age of patients was 19.2 ± 7.7 years (range: 5–53). Complications had occurred up to 37 years from the time of surgery, with most of the cases (22.5%) occurring during the operation. The most frequent complications included cardiothoracic issues and displacement of the implanted steel bar. In nine patients, complications led to fatal outcomes. Due to the possible risks of PE surgery, particularly in cosmetically motivated cases, surgeons must exercise extreme caution and remain vigilant for rare and potentially life‐threatening complications.

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Thoracic Outlet Syndrome After the Nuss Procedure for the Correction of Extreme Pectus Excavatum

Cited by 17 publications

References 8 publications

A study about the costoclavicular space in patients with pectus excavatum

A study about the costoclavicular space in patients with pectus excavatum

Complex Regional Pain Syndrome Following the Nuss Procedure for Severe Pectus Excavatum

Post‐operative arrest following pectus excavatum repair: A case report with a systematic review of the published case reports

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