Minimally invasive repair of pectus excavatum
Authors:
M. Rygl 1; M. Vyhnánek 1; A. Kučera 1; V. Mixa 2; V. Věžníková 3; J. Šnajdauf 1
Authors place of work:
Klinika dětské chirurgie UK 2. LF a FN Motol, Subkatedra dětské chirurgie IPVZ, Prahapřednosta prof. MUDr. J. Šnajdauf, DrSc.
1; Klinika anesteziologie, resuscitace a intenzivní medicíny UK 2. LF a FN Motol, Prahapřednosta prof. MUDr. K. Cvachovec, CSc., MBA
2; Klinika zobrazovacích metod UK 2. LF a FN Motol, Prahapřednosta doc. MUDr. M. Roček, CSc.
3
Published in the journal:
Čes-slov Pediat 2013; 68 (6): 357-363.
Category:
Original Papers
Summary
Aim:
Minimally invasive repair of pectus excavatum (MIRPE) has become novel standard procedure for correction of pectus excavatum (PE). This report presents the surgical technique MIRPE and evaluates the results in children and adolescents.
Methods:
Method MIRPE is based on gradual remodeling effect of retrosternal steel bar on chest wall deformity. A convex bar is inserted through small bilateral thoracic incisions under thoracoscopic vision. After 3 years, when permanent remodeling of deformed cartilages has occurred, the bar is removed. The retrospective study of medical reports, imaging and clinical examinations analyzed safety and efficacy of MIRPE in 204 adolescent with PE.
Results:
During the period 2005-2012 the MIRPE was performed on 31 girls and 173 boys, the mean age at the time of surgery was 16.6 y (range 13–28 y). The mean Haller index was 4.7 (range 2.7–20.5). The most common complication was pneumothorax (3.4%), less common problems included atelectasis (1.4%), fluidothorax (0.5%), and lung injury (0.5%). The wound complications were abscess (2.5%), dehiscence (1%), and seroma (0.5%). The incidence of bar displacement was 2%. The most serious complication was cardiac perforation when inserting Lorenz introducer. This occurred in a 16-year-old girl, and she required urgent sternotomy with right atrial repair, she recovered well.
Conclusions:
Pectus excavatum deformity may significantly affect physical and mental quality of life in adolescents and in some cases can be treated surgically. Minimally invasive repair of pectus excavatum (MIRPE) is a safe method with low risk of complications, which reduces the operational stress and has better cosmetic results.
Key words:
pectus excavatum, minimally invasive repair of pectus excavatum, Haller index
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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