Dawn E Jaroszewski1, Eric W Fonkalsrud. 1. Division of Cardiothoracic Surgery, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California 90095-1749, USA.
Abstract
BACKGROUND: Severe pectus chest deformities are common, often causing physiologic impairment. Patients who do not undergo repair during childhood often experience progressive worsening of symptoms during adulthood. There are few published reports regarding pectus repair in adults. METHODS: A retrospective review from January 1986 through January 2007 was performed on patients age 19 years and older, who underwent surgical correction of pectus excavatum (PE) or carinatum (PC) at one hospital. RESULTS: Adult patients, including 268 PE (84%), 41 PC (13%), and 11 with combined deformities (3%) underwent open repair with minimal cartilage resection and a temporary internal support strut. Ages ranged from 19 to 67 years (mean, 27). Patients experienced dyspnea, decreased endurance and tachypnea with mild exertion (99%), tachycardia (94%), and chest pain (69%). All patients reported worsening of symptoms during adolescence, which became more severe during adulthood. The mean severity score for PC and PE was 1.8 and 5.8, respectively (normal = 2.5). All patients experienced improvement in symptoms within four months after repair. Mean hospitalization was 2.9 days. Complications included pleural effusion (n = 8), pneumothorax (n = 4), and pericarditis (n = 2). Small localized protrusions persisted in eight patients. Four patients underwent repair of mild recurrent deformities. There were no deaths. Ninety-eight percent reported considerable improvement in exercise tolerance and indicated postoperative results as very good or excellent. CONCLUSIONS: Uncorrected pectus deformities persist after childhood and often cause worsening symptoms with increasing age. Repair can be performed in adults with low morbidity, short hospital stay, and considerable improvement in physiologic function.
BACKGROUND: Severe pectus chest deformities are common, often causing physiologic impairment. Patients who do not undergo repair during childhood often experience progressive worsening of symptoms during adulthood. There are few published reports regarding pectus repair in adults. METHODS: A retrospective review from January 1986 through January 2007 was performed on patients age 19 years and older, who underwent surgical correction of pectus excavatum (PE) or carinatum (PC) at one hospital. RESULTS: Adult patients, including 268 PE (84%), 41 PC (13%), and 11 with combined deformities (3%) underwent open repair with minimal cartilage resection and a temporary internal support strut. Ages ranged from 19 to 67 years (mean, 27). Patients experienced dyspnea, decreased endurance and tachypnea with mild exertion (99%), tachycardia (94%), and chest pain (69%). All patients reported worsening of symptoms during adolescence, which became more severe during adulthood. The mean severity score for PC and PE was 1.8 and 5.8, respectively (normal = 2.5). All patients experienced improvement in symptoms within four months after repair. Mean hospitalization was 2.9 days. Complications included pleural effusion (n = 8), pneumothorax (n = 4), and pericarditis (n = 2). Small localized protrusions persisted in eight patients. Four patients underwent repair of mild recurrent deformities. There were no deaths. Ninety-eight percent reported considerable improvement in exercise tolerance and indicated postoperative results as very good or excellent. CONCLUSIONS: Uncorrected pectus deformities persist after childhood and often cause worsening symptoms with increasing age. Repair can be performed in adults with low morbidity, short hospital stay, and considerable improvement in physiologic function.
Authors: Esra Akyüz Özkan; Hashem E Khosrashahi; Halil İbrahim Serin; Bayram Metin; Mahmut Kılıç; U Aliye Geçit Journal: Interact Cardiovasc Thorac Surg Date: 2016-03-18
Authors: Yoo Sang Yoon; Hong Kwan Kim; Yong Soo Choi; Kwhanmien Kim; Young Mog Shim; Jhingook Kim Journal: World J Surg Date: 2010-07 Impact factor: 3.352