초록접수 현황
| 17F-245 | 구연 미채택시 포럼 발표 |
How does the Pectus Bar Affect Thoracic Cage Dynamics during Respiratory Movements?
Seok Beom Hong, Mi-Hyoung Moon, Kyung Soo Kim, Young Kyu Moon, 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 : The impact of pectus bars to thoracic cage dynamics has not been discovered. The aim of this study is to reveal how bars attribute to hinder the chest wall movements during the respiratory cycle.
Methods : We analyzed full inspiration and expiration chest x-rays, which were obtained from pectus deformity patients. From 2016 to 2017, 506 sets of x-rays were collected. We measured thoracic dimensions in three different directions: 1)transverse dimension(TD), 2)anteroposterior dimension(APD)-representing chest wall recoil, and 3)lung height(LH)-reflecting diaphragm movements. These parameters were analyzed among three different phases: before bar insertion; bar in place; and after bar removal.
Results : Chest wall movements were decreased after bar insertion: TD 4.38 to 2.41% (p<0.01) and APD 12.40 to 6.59% (p<0.01), whereas diaphragm movements were preserved (LH: 18.60 to 21.09%, p=0.14). Multiple bars in adults seemed to be more restrictive than single bars in children: TD 3.30 vs 4.65% (p=0.03); APD 6.33 vs 7.08% (p=0.70). However, LH was higher in multiple bar patients than single bar patients (14.50 vs 9.35%, p<0.01). After bar removal, the thoracic dimensions were returned to the preoperative levels: TD 4.81 to 5.52% (p=0.33); APD 10.83 to 9.44% (p=0.32); LH 10.77 to 12.20% (p=0.30).
Conclusion : Our study revealed that pectus bars restrained chest wall movements in some degree to the antero-posterior and lateral directions, but compensated by increased movement of the diaphragm in multiple bar patients. In addition, movements were restored after bar removal. The compensatory diaphragm dynamics contribute to the regulation of the respiratory mechanism during in possession of the bar.
Methods : We analyzed full inspiration and expiration chest x-rays, which were obtained from pectus deformity patients. From 2016 to 2017, 506 sets of x-rays were collected. We measured thoracic dimensions in three different directions: 1)transverse dimension(TD), 2)anteroposterior dimension(APD)-representing chest wall recoil, and 3)lung height(LH)-reflecting diaphragm movements. These parameters were analyzed among three different phases: before bar insertion; bar in place; and after bar removal.
Results : Chest wall movements were decreased after bar insertion: TD 4.38 to 2.41% (p<0.01) and APD 12.40 to 6.59% (p<0.01), whereas diaphragm movements were preserved (LH: 18.60 to 21.09%, p=0.14). Multiple bars in adults seemed to be more restrictive than single bars in children: TD 3.30 vs 4.65% (p=0.03); APD 6.33 vs 7.08% (p=0.70). However, LH was higher in multiple bar patients than single bar patients (14.50 vs 9.35%, p<0.01). After bar removal, the thoracic dimensions were returned to the preoperative levels: TD 4.81 to 5.52% (p=0.33); APD 10.83 to 9.44% (p=0.32); LH 10.77 to 12.20% (p=0.30).
Conclusion : Our study revealed that pectus bars restrained chest wall movements in some degree to the antero-posterior and lateral directions, but compensated by increased movement of the diaphragm in multiple bar patients. In addition, movements were restored after bar removal. The compensatory diaphragm dynamics contribute to the regulation of the respiratory mechanism during in possession of the bar.
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: Seok Beom Hong, E-mail : seok_beom@naver.com