Buchwald Joachim, Ligarski Dariusz, Polewczyk Tomasz
Department of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój, Poland.
Department of Radiology, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój, Poland.
Kardiochir Torakochirurgia Pol. 2020 Dec;17(4):173-177. doi: 10.5114/kitp.2020.102336. Epub 2021 Jan 15.
Pectus excavatum is a depression of the sternum. Pectus carinatum, in contrast, is the convexity of the sternum. The mixed form is an intermediate condition. Surgical intervention is the treatment of choice. The techniques most commonly used include the Ravitch and the Nuss procedures.
To assess the immediate and long-term results of the original modification of the surgical treatment for anterior chest wall deformation.
The modification is based on the Ravitch procedure. The difference is that the ends of the resected cartilages are shaped like a blade in order to be inserted into the previously prepared wedge-shaped hollows located on both edges of the sternum. The result is long lasting without the need to use additional brackets.
The follow-up examinations performed in 72 patients, including 57 boys and 15 girls, were the basis to produce long-term results. As for the type of deformity, out of 57 patients operated on due to pectus excavatum, 43 expressed satisfaction with the very good result. Similar satisfaction was reported in 7 out of 11 patients operated on due to pectus carinatum. There were 4 cases with the mixed form who had very good long-term results. Wound dehiscence was observed in 13 subjects, with one documented recurrence.
The alternative treatment we propose is a one-time procedure without the need to use additional support of the sternum. Good long-term results make the procedure suitable to be used more frequently in all types of deformities.
漏斗胸是胸骨凹陷。相比之下，鸡胸是胸骨突出。混合型是一种中间状态。手术干预是首选治疗方法。最常用的技术包括Ravitch手术和Nuss手术。
评估前胸壁畸形手术治疗原始改良术式的近期和长期效果。
该改良术式基于Ravitch手术。不同之处在于，切除软骨的末端形状像刀片，以便插入预先在胸骨两侧制备的楔形凹槽中。结果持久，无需使用额外的支架。
对72例患者进行的随访检查（包括57名男孩和15名女孩）是得出长期效果的依据。至于畸形类型，在57例因漏斗胸接受手术的患者中，43例对非常好的手术效果表示满意。在11例因鸡胸接受手术的患者中，有7例报告了类似的满意度。有4例混合型患者获得了非常好的长期效果。13例患者出现伤口裂开，有1例记录到复发。
我们提出的替代治疗方法是一种一次性手术，无需使用额外的胸骨支撑。良好的长期效果使该手术更适合在所有类型的畸形中更频繁地使用。
