Thoracoscopic Nuss Procedure for Young Adults With Pectus Excavatum: Excellent Midterm Results and Patient Satisfaction

Hanna, Waël C.; Ko, Michael Augustine; Blitz, Maurice; Shargall, Yaron; Compeau, Christopher

doi:10.1016/j.athoracsur.2013.04.093

Cited by 55 publications

(46 citation statements)

References 16 publications

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“…В литературе описано более 80 раз-личных вариантов хирургических вмешательств и их модификаций для коррекции ВДГК [9][10][11][12][13][14][15][16]. Но, несмотря на большое количество различ-ных методик ее оперативного лечения, отдален-ные результаты не всегда удовлетворяют хирурга и пациента [17][18][19][20].…”

Section: Introductionunclassified

Treatment of funnel chest in children

Стальмахович

Николаевич²,

Дуденков³

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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1 Иркутская государственная медицинская академия последипломного образования -филиал ФГБОУ ДПО РМАНПО Минздрава России, Иркутск; 2 ОГАУЗ «Ангарская детская больница № 1», Ангарск; 3 ГБУЗ «Иркутская областная детская клиническая больница», Иркутск Актуальность. Частота заболевания, высокий процент неудовлетворительных результатов после торакопла-стики по поводу воронкообразной деформации грудной клетки являются причиной дальнейшего поиска но-вых технических приемов оперативного лечения. Цель исследования: улучшение результатов лечения воронкообразной деформации грудной клетки у детей. Материал и методы. Анализируются результаты торакопластики у 230 детей с воронкообразной деформацией грудной клетки. Применялись две методики операций: классическая торакопластика по Nuss (у 114 детей) и ее авторская модификация (у 116 детей), предусматривающая торакоскопию с обеих сторон, надсечение хрящей деформированных ребер и эндоскопическое продольное частичное рассечение кортикальной пластинки груди-ны путем создания подкожной эмфиземы в проекции грудины. Результаты. Установлено, что статистически значимого различия по продолжительности выполнения опера-ции, ее травматичности в анализируемых группах не выявлено. Частичный рецидив заболевания развивается у детей, перенесших торакопластику в возрасте до 7 лет, независимо от используемого метода торакоплас-тики. Выводы. Авторский метод торакопластики наиболее эффективен у детей с ригидной формой грудной клетки в возрасте старше 14 лет, так как позволил уменьшить давление грудино-реберного комплекса на металлокон-струкцию и самой пластины на опорные ребра, что облегчало выведение грудины в физиологическое положе-ние, предупреждало деформацию/пролежни опорных ребер.Ключевые слова: воронкообразная деформация грудной клетки, Nuss-технология, авторский способ кор-рекции. TREATMENT OF FUNNEL CHEST IN CHILDREN

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Section: Introductionunclassified

Treatment of funnel chest in children

Стальмахович

Николаевич²,

Дуденков³

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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“…Since pectus deformities may cause both physical and psychological problems, issues related to the quality of life of these patients are of particular concern (2)(3)(4)(5). Pectus deformities were found to be associated with decreased quality of life, low self-esteem, and increased psychosocial problems (3,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

“…Abramson (13) also applied a similar technique for PC (MIRPC) in 2004. Recent studies suggest that minimal invasive repair of pectus deformities improves the quality of life, body image, and self-esteem (3,4,6,7,(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Psychosocial functioning in pediatric patients with pectus excavatum and pectus carinatum

Bahadir¹,

Bektaşoğlu²,

Eser³

et al. 2017

Turk J Med Sci

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Background/aim: Pectus excavatum and pectus carinatum are the most commonly seen anterior chest wall deformities. Recent studies reveal that minimal invasive repair of pectus deformities improves the quality of life. Our aim is to assess the psychosocial functioning and sociodemographic characteristics of pediatric patients with pectus deformities and evaluate the differences between patients operated on with minimal invasive repair techniques and nonoperated patients.Materials and methods: Thirty-two patients with pectus deformities who were operated on 6 months or more before and 31 nonoperated patients participated in the study. The Children's Depression Inventory, Piers-Harris Children's Self-Concept Scale, Capa Social Phobia Scale for Children and Adolescents, Strengths and Difficulties Questionnaire -Self-Report Version (SDQ-SR), and State-Trait Anxiety Inventory for Children -Trait Version were completed by the patients. The SDQ-Parent Report Version (SDQ-PR) was completed by their parents.Results: There were no statistically significant differences between operated and nonoperated patient groups in terms of total scores on the psychiatric rating scales. Prosocial behavior subscale scores in SDQ-SR (P = 0.013) and SDQ-PR (P = 0.019) were lower in the operated group. Conclusion:Prosocial behavior levels were lower in the operated group. Further exploration of the psychosocial profile of pediatric patients with pectus deformities would better elucidate their needs in the course of their socioemotional development.

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“…2,3 Nevertheless, PE cases have mostly been a cosmetic defect including issues regarding body image which may significantly impact a person's quality of life, low self-esteem, and increased psychosocial problems with PE patients mostly complaining of chest pain, difficulty breathing, decreased cardiac output and decreased exercise capacity depending on its severity. [4][5][6][13][14][15][16][17] Morphological differences in pectus excavatum may result in different effects on pulmonary function as well as cardiac morphology and function. 5,6 Symptoms of untreated patients can progress with age, and it's recommended that the deformity is surgically treated in both young and adult patients.…”

Section: Introductionmentioning

confidence: 99%

“…2,[8][9][10] In addition, recent studies have suggested that minimal invasive repair of PE improves the quality of life, body image, and the patient's self-esteem. 15,16,[18][19][20] To engage in light physical exercise such as jogging and cycling slowly according to his pace Patient's information: A 12-year-old boy with his parents visited our department's pediatric cardiac and thoracic outpatient clinic at the province city hospital in the background of severe recurrent chest pain accompanied by chest tightness. The patient was tall, thin with clear consciousness denied any trauma to the chest and was also not on any medications and at the time of visit he was not in any acute distress what so ever.…”

Section: Introductionmentioning

confidence: 99%

Pectus excavactum-insights into its diagnosis and the current treatment options along with its clinical outcomes: two case reports

et al. 2018

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Pectus excavatum (PE) is a congenital sternal depression, one of the most frequent major congenital malformations of the chest wall. Generally, the malformation is not associated with functional disorders and often constitutes an aesthetic alteration with significant psychological distress. Nevertheless, the surgical repair of PE in childhood has been a well-established procedure with modified Ravitch repair (MRR) and minimally invasive repair (MIR) by Nuss been the two most popular methods of corrections. As a means of concealing the ugly skin scars caused by the MRR technique, the procedure was however highly modified with the use of bilateral inframammarian separated skin incisions. However, MIR has been a preferable technique due to its shorter operative time and minimal blood loss, but its postoperative complications have so far seemed to be its limiting factor whereas, extensive and combined deformities of the ventral chest wall are classically corrected using either MIR by Nuss and the MRR technique. Notwithstanding, Conservative treatment using alloplastic implants or vacuum bell to elevate the sternum in patients with mild PE defect is becoming a potential alternative and a means of preventing unnecessary surgical procedures mostly in mild funnel chest. Presented here is a case of PE surgical correction in a 12-year-old boy and an 11-year-old girl with pectus bar dislodgment. This article analyses the chain of events between both patients, reviews the literature on the subject and other currently available treatment options.

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Thoracoscopic Nuss Procedure for Young Adults With Pectus Excavatum: Excellent Midterm Results and Patient Satisfaction

Cited by 55 publications

References 16 publications

Treatment of funnel chest in children

Treatment of funnel chest in children

Psychosocial functioning in pediatric patients with pectus excavatum and pectus carinatum

Pectus excavactum-insights into its diagnosis and the current treatment options along with its clinical outcomes: two case reports

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