Eun Young Rha1, Jun Hyeok Kim1, Gyeol Yoo1, Seha Ahn2, Jun Lee2, Jin Yong Jeong2. 1. Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. 2. Department of Thoracic and Cardiovascular Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract
BACKGROUND: Using a simple and intuitive method, we evaluated changes in the dimensions of the thoracic cavity of pectus excavatum (PE) patients following the Nuss procedure. METHODS: We performed a retrospective review of 141 patients who had undergone the Nuss procedure. The thoracic cavity was visualized using computed tomography (CT) scans and its dimensions determined by measuring the anteroposterior (AP) and transverse (T) diameters at three anatomical landmarks (the jugular notch, and manubriosternal and xiphisternal joints). The Wilcoxon signed-rank test was used to compare differences between preoperative and postoperative parameters. Kruskal-Wallis tests were performed to compare differences among groups in patient age, type of PE, and number of inserted bars. RESULTS: Of the 141 patients (115 men, 26 women), 87 had symmetric and 54 had asymmetric defects. The postoperative AP diameters at the manubriosternal and xiphisternal joints were significantly higher than their preoperative values, whereas the Haller indices and T diameters at the three anatomical landmarks were significantly lower than their preoperative values. In the multiple bars group, the postoperative AP diameters increased significantly compared with their preoperative values. In the multiple bars group, and in patients aged above 13 years, the postoperative T diameters at all three anatomical landmarks decreased significantly compared with their preoperative values. CONCLUSIONS: Correction of anterior depression of the sternum and compensatory narrowing of the chest width were observed in PE patients following the Nuss procedure. Further research will be necessary to determine the relationship between these observations and postoperative changes in chest volume.
BACKGROUND: Using a simple and intuitive method, we evaluated changes in the dimensions of the thoracic cavity of pectus excavatum (PE) patients following the Nuss procedure. METHODS: We performed a retrospective review of 141 patients who had undergone the Nuss procedure. The thoracic cavity was visualized using computed tomography (CT) scans and its dimensions determined by measuring the anteroposterior (AP) and transverse (T) diameters at three anatomical landmarks (the jugular notch, and manubriosternal and xiphisternal joints). The Wilcoxon signed-rank test was used to compare differences between preoperative and postoperative parameters. Kruskal-Wallis tests were performed to compare differences among groups in patient age, type of PE, and number of inserted bars. RESULTS: Of the 141 patients (115 men, 26 women), 87 had symmetric and 54 had asymmetric defects. The postoperative AP diameters at the manubriosternal and xiphisternal joints were significantly higher than their preoperative values, whereas the Haller indices and T diameters at the three anatomical landmarks were significantly lower than their preoperative values. In the multiple bars group, the postoperative AP diameters increased significantly compared with their preoperative values. In the multiple bars group, and in patients aged above 13 years, the postoperative T diameters at all three anatomical landmarks decreased significantly compared with their preoperative values. CONCLUSIONS: Correction of anterior depression of the sternum and compensatory narrowing of the chest width were observed in PE patients following the Nuss procedure. Further research will be necessary to determine the relationship between these observations and postoperative changes in chest volume.
Authors: Shawn D St Peter; David Juang; Carissa L Garey; Carey A Laituri; Daniel J Ostlie; Ronald J Sharp; Charles L Snyder Journal: J Pediatr Surg Date: 2011-12 Impact factor: 2.545
Authors: João Gomes-Fonseca; João L Vilaça; Tiago Henriques-Coelho; Bruno Direito-Santos; António C M Pinho; Jaime C Fonseca; Jorge Correia-Pinto Journal: J Pediatr Surg Date: 2017-01-07 Impact factor: 2.545
Authors: Mark J Cartoski; Donald Nuss; Michael J Goretsky; Virginia K Proud; Daniel P Croitoru; Tina Gustin; Karen Mitchell; Ellen Vasser; Robert E Kelly Journal: J Pediatr Surg Date: 2006-09 Impact factor: 2.545
Authors: Daniel C Aronson; Remko P Bosgraaf; Eva-Maria Merz; Reindert P van Steenwijk; Wim M C van Aalderen; Robertine van Baren Journal: World J Surg Date: 2007-05-30 Impact factor: 3.352