Peña A, Pérez L, Nurko S, Dorenbaum D
Am Surg. 1981 May;47(5):215-8.
Eighty cases of anterior chest wall deformities were reviewed. The group consisted of 47 patients with pectus carinatum and 33 patients with pectus excavatum. This 1.4:1 distribution has not been reported in the literature, where a 1:10 distribution is regularly cited. Important bronchopulmonary changes were found by chest x-rays in both groups. Formerly, alterations in pectus excavatum were attributed to the mechanical effect of the depressed sternum. The presence of the same symptoms and bronchopulmonary radiographic changes in patients with pectus carinatum suggests a primary pulmonary defect in both entities. However, bronchopulmonary changes were more prominent in patients with pectus excavatum than in patients with carinatum, which suggests that mechanical compression enhances the problem. Postoperative radiologic improvement was similar in both groups. The patients underwent a surgical procedure that included a sternal osteotomy and a complete removal of the costal cartilages. All patients survived. There were two recurrences. Considerable postoperative overgrowth of the unresected second costal cartilages was observed, hence our recommendation for routine removal of these structures. The habitus of prominent abdomen and stooped shoulders was not modified by the operation, but important symptomatic improvement and some radiologic improvement were observed in both groups.
回顾了80例前胸壁畸形病例。该组包括47例鸡胸患者和33例漏斗胸患者。这种1.4:1的分布在文献中未见报道，文献中经常引用的分布比例为1:10。两组患者胸部X光检查均发现重要的支气管肺改变。以前，漏斗胸的改变归因于凹陷胸骨的机械作用。鸡胸患者出现相同症状和支气管肺影像学改变提示这两种情况均存在原发性肺部缺陷。然而，漏斗胸患者的支气管肺改变比鸡胸患者更明显，这表明机械压迫加剧了问题。两组术后影像学改善相似。患者接受了包括胸骨截骨术和完全切除肋软骨的手术。所有患者均存活。有两例复发。观察到未切除的第二肋软骨术后有相当程度的过度生长，因此我们建议常规切除这些结构。突出腹部和驼背的体型并未因手术而改变，但两组均观察到重要的症状改善和一些影像学改善。
