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Published in: Journal of Cardiothoracic Surgery 1/2021

Open Access 01-12-2021 | Research article

A new minimally invasive technique for correction of pectus carinatum

Authors: Wei Ping, Shengling Fu, Yangkai Li, Jun Yu, Ni Zhang, Xiangning Fu, Yixin Cai

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

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Abstract

Background

The Abramson technique for the correction of pectus carinatum (PC) is commonly performed worldwide. However, the postoperative complications of this technique related to bar fixation, including wire breakage and bar displacement, are relatively high. In this study, a new minimally invasive technique for correction of PC is described, in which the pectus bar is secured by bilateral selected ribs, and for which no special fixation to the rib is needed.

Methods

The procedure was performed by placing the pectus bar subcutaneously over the sternum with both ends of the bar passing through the intercostal space of the selected rib at the anterior axillary line. The protruding sternum was depressed by the bar positioned in this 2 intra- and 2 extra-thorax manners. Between October 2011 and September 2019, 42 patients with PC underwent this procedure.

Results

Satisfactory cosmetic results were obtained in all the patients. The mean operation time was 87.14 min, and the mean postoperative stay was 4.05 days. Wound infection occurred in 3 patients, 2 were cured by antibiotics, and 1 received bar removal 4 months after the initial operation due to the exposure of the implant resulting from uncontrolled infection. Mild pneumothorax was found in 3 patients and cured by conservative treatment. One patient suffered from hydropneumothorax, which was treated with chest drainage. The bars were removed at a mean duration of 24.4 months since primary repair in 20 patients without recurrence.

Conclusions

This new technique for minimally invasive correction of PC deformity is a safe and feasible procedure yielding good results and minimal complications.
Literature
1.
go back to reference Goretsky MJ, Kaelly RJ, Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med Clin. 2004;15(3):455–71.CrossRef Goretsky MJ, Kaelly RJ, Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med Clin. 2004;15(3):455–71.CrossRef
2.
go back to reference Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin. 2010;20(4):563–74.CrossRef Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin. 2010;20(4):563–74.CrossRef
3.
go back to reference Abramson H. A minimally invasive technique to repair pectus carinatum Preliminary report. Arch Bronconeumol. 2005;41(6):349–51.CrossRef Abramson H. A minimally invasive technique to repair pectus carinatum Preliminary report. Arch Bronconeumol. 2005;41(6):349–51.CrossRef
4.
go back to reference Abramson H, D’Agostino J, Wuscovi S. A 5-year experience with a minimally invasive technique for pectus carinatum repair. J Pediatr Surg. 2009;44(1):118–24.CrossRef Abramson H, D’Agostino J, Wuscovi S. A 5-year experience with a minimally invasive technique for pectus carinatum repair. J Pediatr Surg. 2009;44(1):118–24.CrossRef
5.
go back to reference Bilgin M. Early results of minimal invasive surgery in patients with pectus carinatum. Turk J Thorac Cardiovasc Surg. 2012;20:307–11.CrossRef Bilgin M. Early results of minimal invasive surgery in patients with pectus carinatum. Turk J Thorac Cardiovasc Surg. 2012;20:307–11.CrossRef
6.
go back to reference Abramson H, Aragone X, Blanco JB, Ciano A, Abramson L. Minimally invasive repair of pectus carinatum and how to deal with complications. J Vis Surg. 2016;2:64.CrossRef Abramson H, Aragone X, Blanco JB, Ciano A, Abramson L. Minimally invasive repair of pectus carinatum and how to deal with complications. J Vis Surg. 2016;2:64.CrossRef
7.
go back to reference Yuksel M, Lacin T, Ermerak NO, Sirzai EY, Sayan B. Minimally invasive repair of pectus carinatum. Ann Thorac Surg. 2018;105(3):915–23.CrossRef Yuksel M, Lacin T, Ermerak NO, Sirzai EY, Sayan B. Minimally invasive repair of pectus carinatum. Ann Thorac Surg. 2018;105(3):915–23.CrossRef
8.
go back to reference Yuksel M, Bostanci K, Evman S. Minimally invasive repair of pectus carinatum using a newly designed bar and stabilizer: a single-institution experience. Eur J Cardiothorac Surg. 2011;40(2):339–42.PubMed Yuksel M, Bostanci K, Evman S. Minimally invasive repair of pectus carinatum using a newly designed bar and stabilizer: a single-institution experience. Eur J Cardiothorac Surg. 2011;40(2):339–42.PubMed
9.
go back to reference Lee SY, Song IH, Lee SJ. Minimal invasive extrathoracic presternal compression using a metal bar for correction of pectus carinatum. Pediar Surg Int. 2014;30(1):25–30.CrossRef Lee SY, Song IH, Lee SJ. Minimal invasive extrathoracic presternal compression using a metal bar for correction of pectus carinatum. Pediar Surg Int. 2014;30(1):25–30.CrossRef
10.
go back to reference Ozkaya M, Bilgin M. Minimally invasive repair of pectus carinatum: a retrospective analysis based on a single surgeon’s 10 years of experience. Gen Thorac Cardiovasc Surg. 2018;66(11):653–7.CrossRef Ozkaya M, Bilgin M. Minimally invasive repair of pectus carinatum: a retrospective analysis based on a single surgeon’s 10 years of experience. Gen Thorac Cardiovasc Surg. 2018;66(11):653–7.CrossRef
11.
go back to reference Franco KL. Advanced therapy in thoracic surgery. London: BC Decker Inc.; 2005. p. 145–51. Franco KL. Advanced therapy in thoracic surgery. London: BC Decker Inc.; 2005. p. 145–51.
12.
go back to reference Fonkalsrud EW. Surgical correction of pectus carinatum: lessons learned from 260 patients. J Pediatr Surg. 2008;43(7):1235–43.CrossRef Fonkalsrud EW. Surgical correction of pectus carinatum: lessons learned from 260 patients. J Pediatr Surg. 2008;43(7):1235–43.CrossRef
13.
go back to reference Desmarais TJ, Keller MS. Pectus carinatum. Curr Opin Pediatr. 2013;25(3):375–81.CrossRef Desmarais TJ, Keller MS. Pectus carinatum. Curr Opin Pediatr. 2013;25(3):375–81.CrossRef
14.
go back to reference Sesia SB, Holland-Cunz S, Hacker FM. Dynamic compression system: an effective nonoperative treatment for pectus carinatum: a single center experience in Basel. Switzerland Eur J Pediatr Surg. 2016;26(6):481–6.CrossRef Sesia SB, Holland-Cunz S, Hacker FM. Dynamic compression system: an effective nonoperative treatment for pectus carinatum: a single center experience in Basel. Switzerland Eur J Pediatr Surg. 2016;26(6):481–6.CrossRef
15.
go back to reference Lopez M, Patoir A, Varlet F, Perez-Etchepare E, Tiffet T, Villard A, Tiffet O. Preliminary study of efficacy of dynamic compression system in the correction of typical pectus carinatum. Eur J Cardiothorac Surg. 2013;44(5):e316–9.CrossRef Lopez M, Patoir A, Varlet F, Perez-Etchepare E, Tiffet T, Villard A, Tiffet O. Preliminary study of efficacy of dynamic compression system in the correction of typical pectus carinatum. Eur J Cardiothorac Surg. 2013;44(5):e316–9.CrossRef
16.
go back to reference Frey AS, Garcia VF, Brown RL, Inge TH, Ryckman FC, Cohen AP, Durrett G, Azizkhan RG. Nonoperative management of pectus carinatum. J Pediatr Surg. 2006;41(1):40–5.CrossRef Frey AS, Garcia VF, Brown RL, Inge TH, Ryckman FC, Cohen AP, Durrett G, Azizkhan RG. Nonoperative management of pectus carinatum. J Pediatr Surg. 2006;41(1):40–5.CrossRef
17.
go back to reference Ravitch MM. Operative correction of pectus carinatum (Pigeon Breast). Ann Surg. 1960;151(5):705–14.CrossRef Ravitch MM. Operative correction of pectus carinatum (Pigeon Breast). Ann Surg. 1960;151(5):705–14.CrossRef
18.
go back to reference Lester CW. Pigeon breast (pectus carinatum) and other protrusion deformities of the chest of developmental origin. Ann Surg. 1953;137(4):482–9.CrossRef Lester CW. Pigeon breast (pectus carinatum) and other protrusion deformities of the chest of developmental origin. Ann Surg. 1953;137(4):482–9.CrossRef
19.
go back to reference Kalman A. Initial results with minimally invasive repair of pectus carinatum. J Thorac Cardiovasc Surg. 2009;138(2):434–8.CrossRef Kalman A. Initial results with minimally invasive repair of pectus carinatum. J Thorac Cardiovasc Surg. 2009;138(2):434–8.CrossRef
20.
go back to reference Hock A. Minimal access treatment of pectus carinatum: a preliminary report. Pediar Surg Int. 2009;25(4):337–42.CrossRef Hock A. Minimal access treatment of pectus carinatum: a preliminary report. Pediar Surg Int. 2009;25(4):337–42.CrossRef
21.
go back to reference Tarhan T, Meurer A, Tarhan O. Combined extra-/intrathoracic correction of pectus carinatum and other asymmetric chest wall deformities: a novel technique. Oper Orthop Traumatol. 2018;30(6):469–78.CrossRef Tarhan T, Meurer A, Tarhan O. Combined extra-/intrathoracic correction of pectus carinatum and other asymmetric chest wall deformities: a novel technique. Oper Orthop Traumatol. 2018;30(6):469–78.CrossRef
Metadata
Title
A new minimally invasive technique for correction of pectus carinatum
Authors
Wei Ping
Shengling Fu
Yangkai Li
Jun Yu
Ni Zhang
Xiangning Fu
Yixin Cai
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-021-01663-z

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