L E McMahon1, K N Johnson2, D E Jaroszewski3, J M Acosta4, J C Egan5, J Bae6, H Ngyuen7, D M Notrica8. 1. Phoenix Children's Hospital Department of Surgery, University of Arizona, and Mayo Clinic, Arizona. Electronic address: LMcMahon@phoenixchildrens.com. 2. Department of General Surgery, Mayo Clinic, Arizona. 3. Department of Cardiothoracic Surgery, Mayo Clinic, Arizona. 4. Phoenix Children's Hospital General Surgery, University of Arizona College of Medicine, and Mayo Clinic, Arizona. 5. Phoenix Children's Hospital, University of Arizona College of Medicine, and Mayo Clinic, Arizona. 6. Phoenix Children's Hospital Department of Surgery and Mayo Clinic, Arizona. 7. Department of Pediatric Anesthesiology, Phoenix Children's Hospital. 8. Mayo Clinic, University of Arizona College of Medicine, and Phoenix Children's Hospital Department of Surgery, Arizona.
Abstract
BACKGROUND: Minimally invasive repair of pectus excavatum has become an established method for repair of pectus excavatum. Bar displacement or rotation remains the most common complication of this repair requiring return to the operating room. METHODS: Retrospective review of all patients at a single institution who underwent repair of pectus excavatum using FiberWire for bar stabilization between December 2009 and March 2013 was undertaken. RESULTS: 93 patients underwent minimally invasive pectus repair using FiberWire during the study period. The patients included 73 males and 20 females, with an average age of 14.6years (range 7-21years). Mean operative time was 102minutes (range 56-198minutes). No patients developed wound complications, two patients developed pain because of bar migration and required return to the OR, and no patients had recurrence of their pectus defect because of bar migration during the study period. Median length of follow-up was 17months (range 3-36months). CONCLUSION: Stabilization of pectus bars using circumferential rib fixation with FiberWire at multiple points on both sides of the bar appears to be effective in preventing bar rotation and displacement, and requires minimal change to the operation as it has been previously described. Early experience shows a low rate of complications.
BACKGROUND: Minimally invasive repair of pectus excavatum has become an established method for repair of pectus excavatum. Bar displacement or rotation remains the most common complication of this repair requiring return to the operating room. METHODS: Retrospective review of all patients at a single institution who underwent repair of pectus excavatum using FiberWire for bar stabilization between December 2009 and March 2013 was undertaken. RESULTS: 93 patients underwent minimally invasive pectus repair using FiberWire during the study period. The patients included 73 males and 20 females, with an average age of 14.6years (range 7-21years). Mean operative time was 102minutes (range 56-198minutes). No patients developed wound complications, two patients developed pain because of bar migration and required return to the OR, and no patients had recurrence of their pectus defect because of bar migration during the study period. Median length of follow-up was 17months (range 3-36months). CONCLUSION: Stabilization of pectus bars using circumferential rib fixation with FiberWire at multiple points on both sides of the bar appears to be effective in preventing bar rotation and displacement, and requires minimal change to the operation as it has been previously described. Early experience shows a low rate of complications.
Authors: Dawn E Jaroszewski; MennatAllah M Ewais; Jesse J Lackey; Kelly M Myers; Marianne V Merritt; Joshua D Stearns; Brantley D Gaitan; Ryan C Craner; Michael B Gotway; Tasneem Z Naqvi Journal: J Vis Surg Date: 2016-04-05