Thuerlimann Alice, Tremp Mathias, Oranges Carlo M, Schaefer Dirk J, Kalbermatten Daniel F
Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland.
Plast Reconstr Surg Glob Open. 2017 Dec 28;5(12):e1605. doi: 10.1097/GOX.0000000000001605. eCollection 2017 Dec.
Several methods have been described for the correction of congenital thoracic wall deformities. Our aim was to investigate the feasibility and clinical results of using standard anatomic breast implants with modified anatomic positioning according to the defect in congenital thoracic wall deformities. Between 2014 and 2015, 5 patients diagnosed with pectus excavatum (PE, = 4) or pectus carinatum (PC, = 1) and breast asymmetry or hypoplasia were evaluated. In all patients, a submammary incision and dual-plane subpectoral placement of texturized, anatomic implants were performed. In patients with PE, the lower pole of the implant was positioned medially to compensate for the caved chest. In patients with PC, the lower pole of the anatomic implant was positioned laterally to compensate for the prominent sternum. Outcome measures were satisfaction, minor and major complications, and morbidity. The mean surgery time was 95 ± 14 minutes, and the mean implant volume was 287 ± 56 cm (273 ± 60 cm on the right side and 305 ± 60 cm on the left side). After a median follow-up of 25 months (range: 2-35), all patients healed uneventfully, and a satisfactory correction of the thoracic wall deformity was achieved. Thus, by adjusting the lower pole of anatomic breast implants in a horizontal plane according to the thoracic defect, we showed satisfactory results. Our technique has a low complication rate and can be recommended for the correction of mild to moderate PE or PC.
已有多种方法用于矫正先天性胸壁畸形。我们的目的是研究根据先天性胸壁畸形缺损采用标准解剖型乳房植入物并进行改良解剖定位的可行性和临床效果。2014年至2015年期间,对5例诊断为漏斗胸(PE,n = 4)或鸡胸(PC,n = 1)且伴有乳房不对称或发育不全的患者进行了评估。所有患者均采用乳房下皱襞切口,将表面有纹理的解剖型植入物置于胸大肌下双平面。对于漏斗胸患者,将植入物的下极向内侧定位以补偿凹陷的胸部。对于鸡胸患者,将解剖型植入物的下极向外侧定位以补偿突出的胸骨。观察指标包括满意度、轻微和严重并发症以及发病率。平均手术时间为95±14分钟,平均植入物体积为287±56 cm³(右侧为273±60 cm³,左侧为305±60 cm³)。中位随访25个月(范围:2 - 35个月)后,所有患者均顺利愈合,胸壁畸形得到了满意的矫正。因此,通过根据胸部缺损在水平面上调整解剖型乳房植入物的下极,我们取得了满意的效果。我们的技术并发症发生率低,可推荐用于矫正轻至中度漏斗胸或鸡胸。