초록접수 현황
| 17F-206 | 구연 발표 |
High-end Pectus Surgery: Total Chest Wall Remodeling for Pectus Excavatum, Carinatum, and Mixed Deformities
Kyung Soo Kim, Mi Hyoung Moon, Young Kyu Moon, Seok Beom Hong, Min Namkoong, Hyo Chan An, Hyung Joo Park
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
Purpose : To repair the full spectrum of pectus deformity in best quality, our approach has been “total remodeling” of each given deformity to treat all excavations and focal protuberances in pectus excavatum, carinatum, and all varieties of mixed forms.
The purpose of this study is to illustrate the individual techniques for each specific component of the deformity, and to appraise the results.
Methods : We retrospectively analyzed the data of the total chest wall remodeling approach using pectus bars, which included 1153 patients with pectus excavatum and carinatum or mixed deformities between 2011 and 2016. The surgical technique: the depressed chest wall was lifted with symmetric or asymmetric pectus bars in the fashions of single, parallel, or cross bars. The protruded part(s) of chest wall was compressed with the sandwich technique using the pectus bars or strings.
Results : The major complication rates were: pneumothorax, 15 (1.3%); bar displacement, 6 (0.52%); pleural effusion, 27 (2.3%). There was no mortality. Reoperation was required in 10 patients (0.87%).
The CT index changed after repair: Depression Index, 1.74 ± 0.67 to 1.00 ±0.00 (p<0.001), Asymmetry Index, 1.05 ± 0.22 to 0.97 ± 0.21 (p<0.001), Eccentricity Index, 1.45 ± 0.69 to 1.01 ±0.01 (p<0.001), and Unbalance Index, 1.13 ±0.27 to 1.02 ±0.01 (p<0.001).
Conclusion : The total remodeling of the chest wall in repair of pectus deformity seemed to be effective in solving the morphological variations including pectus excavatum/carinatum complex and lower costal flare. With this concept, we could achieve a decent cosmetic outcome in all forms of complex deformities.
The purpose of this study is to illustrate the individual techniques for each specific component of the deformity, and to appraise the results.
Methods : We retrospectively analyzed the data of the total chest wall remodeling approach using pectus bars, which included 1153 patients with pectus excavatum and carinatum or mixed deformities between 2011 and 2016. The surgical technique: the depressed chest wall was lifted with symmetric or asymmetric pectus bars in the fashions of single, parallel, or cross bars. The protruded part(s) of chest wall was compressed with the sandwich technique using the pectus bars or strings.
Results : The major complication rates were: pneumothorax, 15 (1.3%); bar displacement, 6 (0.52%); pleural effusion, 27 (2.3%). There was no mortality. Reoperation was required in 10 patients (0.87%).
The CT index changed after repair: Depression Index, 1.74 ± 0.67 to 1.00 ±0.00 (p<0.001), Asymmetry Index, 1.05 ± 0.22 to 0.97 ± 0.21 (p<0.001), Eccentricity Index, 1.45 ± 0.69 to 1.01 ±0.01 (p<0.001), and Unbalance Index, 1.13 ±0.27 to 1.02 ±0.01 (p<0.001).
Conclusion : The total remodeling of the chest wall in repair of pectus deformity seemed to be effective in solving the morphological variations including pectus excavatum/carinatum complex and lower costal flare. With this concept, we could achieve a decent cosmetic outcome in all forms of complex deformities.
책임저자: Hyung Joo Park
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
발표자: Hyung Joo Park, E-mail : hyjpark@catholic.ac.kr