Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Sao Paulo, SP 05652900, Brazil.
Interact Cardiovasc Thorac Surg. 2022 Jul 9;35(2). doi: 10.1093/icvts/ivac147.
The association of the diastasis of the rectus abdominis muscle and the medial pectus excavatum was reported. We have been using soft silicone block, sculpted intraoperatively, to correct pectus excavatum. The horizontal access used, 2 cm at a subxiphoid position, allows us to expose the sternum and the rectus abdominis muscles (RAMs). We report a case, male, 31 years presenting medial pectus excavatum and supraumbilical diastasis of the rectus abdominis muscle with a width of 35 mm at the costal arches, and 27 mm at 6 cm from the xiphoid process edge. The muscle borders presented a curved lateral deviation up to the insertion in the costal arches. The necessary space for the implant was dissected and the block was sculpted. The medial and superior aponeurosis borders of the RAM were incised at 6 cm from the xiphoid, and the posterior border of the RAM was released. The aponeurosis borders were brought together, promoting a medial and anterior positioning of the RAM. The inferior border of the implant was attached to the raw superior borders of the RAM. The result was considered satisfactory, and a magnetic resonance image 14 months after showed continuity of the implant and the muscles, promoting a uniform body contour. Registry: CAAE63181616.7.0000.0071.
报道了腹直肌分离与漏斗胸之间的关联。我们一直在使用术中雕刻的软硅胶块来矫正漏斗胸。使用的横向切口在剑突下 2cm 处,可暴露胸骨和腹直肌(RAM)。我们报告了 1 例男性,31 岁,表现为内侧漏斗胸和脐上腹直肌分离,肋弓处宽度为 35mm,剑突边缘 6cm 处宽度为 27mm。肌肉边界呈曲线性外侧偏斜,直至肋弓处的附着点。为植入物需要的空间进行了解剖,并雕刻了块。在距离剑突 6cm 处切开 RAM 的内侧和上侧肌腱边界,释放 RAM 的后边界。将肌腱边界靠拢,促进 RAM 的内侧和前侧定位。植入物的下边界附着在 RAM 的原始上边界上。结果令人满意,磁共振成像显示 14 个月后植入物和肌肉连续,身体轮廓均匀。注册号:CAAE63181616.7.0000.0071.