BACKGROUND: Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown. STUDY DESIGN: The American College of Surgeons 2012 National Surgical Quality Improvement Program-Pediatric (NSQIP-P) participant user file was utilized to identify patients who underwent MIRPE at 50 participant institutions. Outcomes of interest were overall 30-day morbidity, hospital readmission, and reoperation. RESULTS: Chest wall repair designated MIRPE accounted for 0.6% (n = 264) of all surgical cases included in the NSQIP-P database in 2012. The median age at surgical repair was 15.2 years. Thoracoscopy was used in 83.7% of cases. No mediastinal injuries or perioperative blood transfusions were identified. The 30-day readmission rate was 3.8%. Three patients (1.1%) required re-operation due to the following complications: superficial site infection, bar displacement and pneumothorax. The overall morbidity was 3.8% with no incidences of mortality. CONCLUSIONS: This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.
BACKGROUND: Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown. STUDY DESIGN: The American College of Surgeons 2012 National Surgical Quality Improvement Program-Pediatric (NSQIP-P) participant user file was utilized to identify patients who underwent MIRPE at 50 participant institutions. Outcomes of interest were overall 30-day morbidity, hospital readmission, and reoperation. RESULTS: Chest wall repair designated MIRPE accounted for 0.6% (n = 264) of all surgical cases included in the NSQIP-P database in 2012. The median age at surgical repair was 15.2 years. Thoracoscopy was used in 83.7% of cases. No mediastinal injuries or perioperative blood transfusions were identified. The 30-day readmission rate was 3.8%. Three patients (1.1%) required re-operation due to the following complications: superficial site infection, bar displacement and pneumothorax. The overall morbidity was 3.8% with no incidences of mortality. CONCLUSIONS: This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.
Authors: Sara C Fallon; Bethany J Slater; Jed G Nuchtern; Darrell L Cass; Eugene S Kim; Monica E Lopez; Mark V Mazziotti Journal: J Pediatr Surg Date: 2013-05 Impact factor: 2.545
Authors: Jennifer L Bruny; Bruce L Hall; Douglas C Barnhart; Deborah F Billmire; Mark S Dias; Peter W Dillon; Charles Fisher; Kurt F Heiss; William L Hennrikus; Clifford Y Ko; Lawrence Moss; Keith T Oldham; Karen E Richards; Rahul Shah; Charles D Vinocur; Moritz M Ziegler Journal: J Pediatr Surg Date: 2013-01 Impact factor: 2.545
Authors: Robert E Kelly; Robert C Shamberger; Robert B Mellins; Karen K Mitchell; M Louise Lawson; Keith Oldham; Richard G Azizkhan; Andre V Hebra; Donald Nuss; Michael J Goretsky; Ronald J Sharp; George W Holcomb; Walton K T Shim; Stephen M Megison; R Lawrence Moss; Annie H Fecteau; Paul M Colombani; Traci C Bagley; Alan B Moskowitz Journal: J Am Coll Surg Date: 2007-06-21 Impact factor: 6.113
Authors: Peter Dillon; Karl Hammermeister; Elaine Morrato; Allison Kempe; Keith Oldham; Lawrence Moss; Michael Marchildon; Moritz Ziegler; Janet Steeger; Kathy Rowell; Mira Shiloach; William Henderson Journal: Semin Pediatr Surg Date: 2008-05 Impact factor: 2.754
Authors: Christoph Castellani; Johannes Schalamon; Amulya K Saxena; Michael E Höellwarth Journal: Pediatr Surg Int Date: 2008-04-05 Impact factor: 1.827