Department of Pediatric Thoracic Surgery, Guangdong Women and Children Hospital, No. 521, Xingnan Road, Panyu District, Guangzhou 511400, China.
Department of Thoracic Surgery, Anhui Province Children's Hospital, No. 39, Wangjiang East Road, Baohe District, Hefei 230051, China.
Biomed Res Int. 2021 Feb 19;2021:6942329. doi: 10.1155/2021/6942329. eCollection 2021.
Orthotic bracing and minimally invasive surgery are currently the treatment methods for pectus carinatum. We present our experience with the advantages, method selection criteria, and precautions for both treatment methods. A total of 767 pediatric patients (596 boys and 171 girls) with pectus carinatum were retrospectively analyzed. All of them received orthotic bracing, and 108 pediatric patients received minimally invasive surgery, achieving good outcomes. Among the 767 pediatric patients, 644 obtained satisfactory chest appearance through orthotic bracing, with a success rate of 84.0%. Younger pediatric patients had better orthotic outcomes. Among the 123 failure cases, 108 pediatric patients underwent minimally invasive surgery as the treatment. Seventy-six pediatric patients with simple chondrogladiolar prominence underwent a minimally invasive sternal depression procedure, whereas 32 pediatric patients with complex chondromanubrial prominence underwent surgery. All 108 pediatric patients successfully completed the surgery. The operation time was 112.8 ± 23.5 min, and the average length of hospital stay after the surgery was 7 days. A follow-up was conducted for at least 3 months and up to 3 years. The orthotic effect was satisfactory. For younger pediatric patients with pectus carinatum, noninvasive orthotic bracing treatment should be considered first. For older pediatric patients, the failure rate of the bracing was higher, and the outcomes were often unsatisfactory. Especially for patients over 15 years old, minimally invasive sternal depression may be the preferred treatment for pectus carinatum.
矫形支具和微创手术是目前治疗鸡胸的方法。我们介绍了这两种治疗方法的优势、方法选择标准和注意事项。回顾性分析了 767 例小儿鸡胸患者（男 596 例，女 171 例）。所有患者均接受矫形支具治疗，108 例小儿患者接受微创手术治疗，均取得良好效果。767 例小儿患者中，644 例通过矫形支具获得满意的胸廓外观，成功率为 84.0%。年龄较小的小儿患者矫形效果更好。123 例失败病例中，108 例患儿行微创手术治疗。108 例患儿中，76 例单纯肋软骨突出行微创胸骨凹陷术，32 例复杂肋软骨胸骨突出行手术治疗。108 例患儿均顺利完成手术。手术时间为 112.8±23.5min，术后平均住院时间为 7 天。随访至少 3 个月至 3 年，矫形效果满意。对于年龄较小的小儿鸡胸患者，应首先考虑非侵入性矫形支具治疗。对于年龄较大的患儿，支具治疗失败率较高，且效果往往不理想。特别是对于 15 岁以上的患者，微创胸骨凹陷术可能是鸡胸的首选治疗方法。
