MINIMALLY INVASIVE PROCEDURE FOR CORRECTION OF PECTUS CARINATUM_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XUBing ,  LIUWenying

Department of Pediatric Surgery, Sichuan Provincial People's Hospital, Chengdu Sichuan, 610072, P. R. China;

Corresponding?author：

LIUWenying, Email: wenyingl@126.com

Keywords：

Pectus carinatum; Minimally invasive procedure; Correction

DOI：

10.7507/1002-1892.20150097

Video：

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Objective To explore the method and experience in correction of pectus carinatum with minimally invasive procedure. Methods Between June 2010 and January 2014, 30 patients with pectus carinatum were corrected by minimally invasive procedure. There were 21 boys and 9 girls whose average age was 13 years and 2 months (range, from 8 years and 10 months to 18 years and 9 months), including 24 cases of first operation, 2 recurrence after traditional pectus carinatum correction, and 4 cases secondary to median thoracotomy. Thirty patients had symmetric and asymmetric mild pectus carinatum. Results The operation was performed successfully in all patients, and no severe complication occurred. The operation time was 42-95 minutes (mean, 70 minutes). The bleeding volume during operation was 4-30 mL (mean, 10 mL). The time from operation to discharge was 6-10 days (mean, 7 days). The average time of follow-up was 25 months (range, 9-54 months). All surgical wound healed primarily with no infection. The X-ray films showed slight pneumothorax in 7 cases, and it was absorbed after 1 month without treatment. Loosening of internal fixation was found in 1 patient because of trauma at 6 months, and operation was performed again. The bar was removed at 2 years in 21 patients. The patients had good thoracic contour and normal activity. Conclusion Minimally invasive procedure for correction of pectus carinatum is safe and will get satisfactory effect in maintaining thoracic contour. It has also less trauma and shorter operation time.

Citation： XUBing, LIUWenying. MINIMALLY INVASIVE PROCEDURE FOR CORRECTION OF PECTUS CARINATUM. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 448-451. doi: 10.7507/1002-1892.20150097 Copy

1.	Robicsek F, Fokin A. Surgical correction of pectus excavatum and carinatum. J Cardiovasc Surg (Torino), 1999, 40(5):725-731.
2.	Robicsek F. Surgical treatment of pectus carinatum. Chest Surg Clin N Am, 2000, 10(2):357-376.
3.	Fonkalsrud EW, Beanes S. Surgical management of pectus carinatum:30 years' experience. World J Surg, 2001, 25(7):898-903.
4.	Obermeyer RJ, Goretsky MJ. Chest wall deformities in pediatric surgery. Surg Clin North Am, 2012, 92(3):669-684.
5.	Fonkalsrud EW, DeUgarte D, Choi E. Repair of pectus excavatum and carinatum deformities in 116 adults. Ann Surg, 2002, 236(3):304-314.
6.	胡廷澤, 徐志誠, 劉文英, 等. 雞胸的外科治療. 中華胸心血管外科雜志, 2003, 19(4):244.
7.	Fonkalsrud EW. Pectus carinatum:the undertreated chest malformation. Asian J Surg, 2003, 26(4):189-192.
8.	徐志誠, 胡廷澤, 劉文英, 等. 改良手術方法重建雞胸胸壁的療效觀察. 中國修復重建外科雜志, 2005, 19(4):304-305.
9.	徐志誠, 胡廷澤, 張銀柱, 等. 肋軟骨膜對肋軟骨再生與塑形影響的實驗研究. 中國修復重建外科雜志, 2001, 15(6):363-365.
10.	Abramson H. A minimally invasive technique to repair pectus carinatum preliminary report. Arch Bronconeumol, 2005, 41(6):349-351.
11.	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(1):118-124.
12.	徐冰, 劉文英. 微創手術治療雞胸. 中華小兒外科雜志, 2010, 31(12):951-953.
13.	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(1):25-30.
14.	Kang DY, Jung J, Chung S, et al. Factors affecting patient compliance with compressive brace therapy for pectus carinatum. Interact Cardiovasc Thorac Surg, 2014, 19(6):900-903.
15.	肖海波, 張輔賢, 丁芳寶, 等. 微創胸骨沉降術矯治雞胸. 中國胸心血管外科臨床雜志, 2013, 20(5):555-559.
16.	Robicsek F. The Nuss operation for pectus carinatum. Eur J Cardiothorac Surg, 2013, 43(1):127.
17.	Liu T, Liu H, Li Y. Comparison of the Nuss and sternal turnover procedures for primary repair of pectus excavatum. Asian J Surg, 2014, 37(1):30-34.
18.	Neves SC, Pinho AC, Fonseca JC, et al. Finite element analysis of pectus carinatum surgical correction via a minimally invasive approach. Comput Methods Biomech Biomed Engin, 2015, 18(7):711-720.

1. Robicsek F, Fokin A. Surgical correction of pectus excavatum and carinatum. J Cardiovasc Surg (Torino), 1999, 40(5):725-731.
2. Robicsek F. Surgical treatment of pectus carinatum. Chest Surg Clin N Am, 2000, 10(2):357-376.
3. Fonkalsrud EW, Beanes S. Surgical management of pectus carinatum:30 years' experience. World J Surg, 2001, 25(7):898-903.
4. Obermeyer RJ, Goretsky MJ. Chest wall deformities in pediatric surgery. Surg Clin North Am, 2012, 92(3):669-684.
5. Fonkalsrud EW, DeUgarte D, Choi E. Repair of pectus excavatum and carinatum deformities in 116 adults. Ann Surg, 2002, 236(3):304-314.
6. 胡廷澤, 徐志誠, 劉文英, 等. 雞胸的外科治療. 中華胸心血管外科雜志, 2003, 19(4):244.
7. Fonkalsrud EW. Pectus carinatum:the undertreated chest malformation. Asian J Surg, 2003, 26(4):189-192.
8. 徐志誠, 胡廷澤, 劉文英, 等. 改良手術方法重建雞胸胸壁的療效觀察. 中國修復重建外科雜志, 2005, 19(4):304-305.
9. 徐志誠, 胡廷澤, 張銀柱, 等. 肋軟骨膜對肋軟骨再生與塑形影響的實驗研究. 中國修復重建外科雜志, 2001, 15(6):363-365.
10. Abramson H. A minimally invasive technique to repair pectus carinatum preliminary report. Arch Bronconeumol, 2005, 41(6):349-351.
11. 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(1):118-124.
12. 徐冰, 劉文英. 微創手術治療雞胸. 中華小兒外科雜志, 2010, 31(12):951-953.
13. 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(1):25-30.
14. Kang DY, Jung J, Chung S, et al. Factors affecting patient compliance with compressive brace therapy for pectus carinatum. Interact Cardiovasc Thorac Surg, 2014, 19(6):900-903.
15. 肖海波, 張輔賢, 丁芳寶, 等. 微創胸骨沉降術矯治雞胸. 中國胸心血管外科臨床雜志, 2013, 20(5):555-559.
16. Robicsek F. The Nuss operation for pectus carinatum. Eur J Cardiothorac Surg, 2013, 43(1):127.
17. Liu T, Liu H, Li Y. Comparison of the Nuss and sternal turnover procedures for primary repair of pectus excavatum. Asian J Surg, 2014, 37(1):30-34.
18. Neves SC, Pinho AC, Fonseca JC, et al. Finite element analysis of pectus carinatum surgical correction via a minimally invasive approach. Comput Methods Biomech Biomed Engin, 2015, 18(7):711-720.

Chinese Journal of Reparative and Reconstructive Surgery

MINIMALLY INVASIVE PROCEDURE FOR CORRECTION OF PECTUS CARINATUM

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