Eric W Fonkalsrud1. 1. Department of Surgery, University of California, Los Angeles, Medical Center, 90095, USA. efonkalsrud@mednet.ucla.edu
Abstract
BACKGROUND: There is sparse published information regarding surgical management of females with pectus excavatum (PE) or carinatum (PC) deformities. METHODS: During the past 33 years 104 females with PE, and 21 with PC underwent surgical repair using extensive modifications of the Ravitch technique. Seven had previous right breast implants, 3 had prostheses placed in the PE deformity. Nine PE patients underwent successful pregnancy before repair, but had severe third trimester dyspnea. RESULTS: Very good to excellent results were reported by 96% (mean follow-up, 6 years). Increased endurance, decreased dyspnea, reduced chest discomfort, and less tachycardia occurred in all within 6 months. No patients had significant breast asymmetry after repair. Complications included mildly hypertrophic scar (8), transient pleural effusion (3), bar displacement (1), and mild recurrence (3). CONCLUSIONS: Females with symptomatic PE or PC, can be repaired with low morbidity, mild pain, low cost, and improvement in body image and symptoms. Prostheses are not beneficial in the treatment of physiologic symptoms caused by pectus deformities.
BACKGROUND: There is sparse published information regarding surgical management of females with pectus excavatum (PE) or carinatum (PC) deformities. METHODS: During the past 33 years 104 females with PE, and 21 with PC underwent surgical repair using extensive modifications of the Ravitch technique. Seven had previous right breast implants, 3 had prostheses placed in the PE deformity. Nine PE patients underwent successful pregnancy before repair, but had severe third trimester dyspnea. RESULTS: Very good to excellent results were reported by 96% (mean follow-up, 6 years). Increased endurance, decreased dyspnea, reduced chest discomfort, and less tachycardia occurred in all within 6 months. No patients had significant breast asymmetry after repair. Complications included mildly hypertrophic scar (8), transient pleural effusion (3), bar displacement (1), and mild recurrence (3). CONCLUSIONS: Females with symptomatic PE or PC, can be repaired with low morbidity, mild pain, low cost, and improvement in body image and symptoms. Prostheses are not beneficial in the treatment of physiologic symptoms caused by pectus deformities.
Authors: Brittany L Murphy; Nimesh D Naik; Penny L Roskos; Amy E Glasgow; Christopher R Moir; Elizabeth B Habermann; Denise B Klinkner Journal: Pediatr Surg Int Date: 2018-05-09 Impact factor: 1.827