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Minimally Invasive Repair of Pectus Carinatum in Patients Unsuited to Bracing Therapy

  • Suh, Jee-Won (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Joo, Seok (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Geun Dong (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Haam, Seok Jin (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Sungsoo (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Received : 2015.07.21
  • Accepted : 2015.09.30
  • Published : 2016.04.05

Abstract

Background: We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Methods: Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. Results: The mean age of the patients was $24.35{\pm}13.20years$ (range, 14-57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were $2.01{\pm}0.19$ (range, 1.60-2.31), and $2.22{\pm}0.19$ (range, 1.87-2.50), respectively (p-value=0.01), and the median hospital stay was $7.09{\pm}2.91days$ (range, 5-15 days). Only one patient experienced postoperative complications. Conclusion: Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients.

Keywords

References

  1. Cobben JM, Oostra RJ, van Dijk FS. Pectus excavatum and carinatum. Eur J Med Genet 2014;57:414-7. https://doi.org/10.1016/j.ejmg.2014.04.017
  2. Frey AS, Garcia VF, Brown RL, et al. Nonoperative management of pectus carinatum. J Pediatr Surg 2006;41:40-5. https://doi.org/10.1016/j.jpedsurg.2005.10.076
  3. Ravitch MM. Unusual sternal deformity with cardiac symptoms operative correction. J Thorac Surg 1952;23:138-44.
  4. Abramson H. A minimally invasive technique to repair pectus carinatum: preliminary report. Arch Bronconeumol 2005;41:349-51.
  5. Abramson H, D'Agostino J, Wuscovi S. A 5-year experience with a minimally invasive technique for pectus carinatum repair. J Pediatr Surg 2009;44:118-23. https://doi.org/10.1016/j.jpedsurg.2008.10.020
  6. Yuksel M, Bostanci K, Evman S. Minimally invasive repair of pectus carinatum using a newly designed bar and stabilizer: a single-institution experience. Eur J Cardiothorac Surg 2011;40:339-42.
  7. Lakoma A, Kim ES. Current readings: surgical repair experience of congenital chest wall deformities. Semin Thorac Cardiovasc Surg 2013;25:317-22. https://doi.org/10.1053/j.semtcvs.2013.12.001
  8. Lee RT, Moorman S, Schneider M, Sigalet DL. Bracing is an effective therapy for pectus carinatum: interim results. J Pediatr Surg 2013;48:184-90. https://doi.org/10.1016/j.jpedsurg.2012.10.037
  9. Desmarais TJ, Keller MS. Pectus carinatum. Curr Opin Pediatr 2013;25:375-81. https://doi.org/10.1097/MOP.0b013e3283604088
  10. Lee SY, Song IH, Lee SJ. Minimal invasive extrathoracic presternal compression using a metal bar for correction of pectus carinatum. Pediatr Surg Int 2014;30:25-30. https://doi.org/10.1007/s00383-013-3419-0
  11. Jaroszewski DE, Fonkalsrud EW. Repair of pectus chest deformities in 320 adult patients: 21 year experience. Ann Thorac Surg 2007;84:429-33. https://doi.org/10.1016/j.athoracsur.2007.03.077

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