Pampaloni A, Noccioli B, Pampaloni F, Vanini V
U.O. Chirurgia Pediatrica, Azienda Ospedaliera Meyer di Firenze, Italia.
Pediatr Med Chir. 1997 Jan-Feb;19(1):59-64.
Clefts of the sternum have always attracted attention whether for pathological and physiological features or for research of surgical correction. Two cases of sternal cleft, one with partial ectopia cordis, the other with Cantrell's pentalogy, are presented. Embryology, strategies and several surgical techniques are discussed on the grounds of personal experience. The pediatric surgeon can make a choice among a lot of surgical techniques, because the ectopia cordis and Cantrell's pentalogy are very uncommon and the surgical treatment has a difficult codification. The knowledge of several methods of surgical correction is necessary to reduce high mortality of ectopia cordis and Cantrell's pentalogy. Primary repair in the neonatal period is the best type of management for these rare conditions, because simple closure of the sternal defect during the first month of life avoids the more complex reconstruction necessary in older children.
胸骨裂无论是因其病理生理特征还是手术矫正研究,一直都备受关注。本文介绍了两例胸骨裂病例,一例伴有部分心脏异位,另一例伴有坎特雷尔五联症。基于个人经验,对胚胎学、治疗策略及几种手术技术进行了讨论。由于心脏异位和坎特雷尔五联症非常罕见,且手术治疗难以编纂成典,小儿外科医生可以在众多手术技术中进行选择。了解多种手术矫正方法对于降低心脏异位和坎特雷尔五联症的高死亡率是必要的。新生儿期的一期修复是这些罕见病症的最佳治疗方式,因为在出生后的第一个月内简单闭合胸骨缺损可避免大龄儿童所需的更复杂重建。