We have located links that may give you full text access.
Less extensive techniques for repair of pectus carinatum: the undertreated chest deformity.
BACKGROUND: Although patients with pectus carinatum (PC) often experience moderate to severe symptoms, there are sparse published data about the indications for correction, the newer techniques of surgical repair, and the results. This study reviews clinical experience with new, less extensive, open operative techniques for repair of PC.
STUDY DESIGN: Since 1970, 154 patients (119 men and 35 women) with symptomatic PC (mean severity index 1.76) underwent correction at the UCLA Medical Center using modifications of the Ravitch repair. The last 60 consecutive patients had a less extensive open repair with resection of only small chips of cartilage medially and laterally, and suture reattachment of the remaining costal cartilages to the corrected sternum and ribs. For patients with chondromanubrial protrusion, two or three sternal osteotomies were used, and for those with concomitant lower sternal depression, a lower sternal wedge osteotomy was used. For most patients, a temporary support bar anterior to the sternum and cartilages was used for 6 months.
RESULTS: Each of the 154 patients with reduced endurance or dyspnea with mild exercise experienced marked improvement within 6 months. There were no major recurrent deformities; six patients underwent minor surgical revision of localized persistent costal cartilage protrusion or depression. Postoperative complications in the last 60 patients were minor and less frequent, pain was less severe, hospitalization was shorter (mean 2.5 days), and postoperative results were better than when more extensive repairs were used in previous years. With a mean overall followup of 7.9 years, more than 97% of all patients experienced a very good or excellent result.
CONCLUSIONS: New, less extensive, open techniques for repair of PC have low morbidity, short hospital stay, and very good physiologic and cosmetic results.
STUDY DESIGN: Since 1970, 154 patients (119 men and 35 women) with symptomatic PC (mean severity index 1.76) underwent correction at the UCLA Medical Center using modifications of the Ravitch repair. The last 60 consecutive patients had a less extensive open repair with resection of only small chips of cartilage medially and laterally, and suture reattachment of the remaining costal cartilages to the corrected sternum and ribs. For patients with chondromanubrial protrusion, two or three sternal osteotomies were used, and for those with concomitant lower sternal depression, a lower sternal wedge osteotomy was used. For most patients, a temporary support bar anterior to the sternum and cartilages was used for 6 months.
RESULTS: Each of the 154 patients with reduced endurance or dyspnea with mild exercise experienced marked improvement within 6 months. There were no major recurrent deformities; six patients underwent minor surgical revision of localized persistent costal cartilage protrusion or depression. Postoperative complications in the last 60 patients were minor and less frequent, pain was less severe, hospitalization was shorter (mean 2.5 days), and postoperative results were better than when more extensive repairs were used in previous years. With a mean overall followup of 7.9 years, more than 97% of all patients experienced a very good or excellent result.
CONCLUSIONS: New, less extensive, open techniques for repair of PC have low morbidity, short hospital stay, and very good physiologic and cosmetic results.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app