Erschienen in:
02.03.2018 | Review Article
Pigeon chest: comparative analysis of surgical techniques in minimal access repair of pectus carinatum (MARPC)
verfasst von:
Ancuta Muntean, Ionica Stoica, Amulya K. Saxena
Erschienen in:
World Journal of Pediatrics
|
Ausgabe 1/2018
Einloggen, um Zugang zu erhalten
Abstract
Background
After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair for pectus carinatum (MARPC) and compare the outcomes.
Data sources
Literature was reviewed on PubMed with the terms “pectus carinatum”, “minimal access repair”, “thoracoscopy” and “children”.
Results
Twelve MARPC techniques that included 13 articles and 140 patients with mean age 15.46 years met the inclusion criteria. Success rate of corrections was n = 125, about 89% in cumulative reports, with seven articles reporting 100%. The complication rate was 39.28%. Since the pectus bar is placed over the sternum and has a large contact area, skin irritation was the most frequent morbidity (n = 20, 14.28%). However, within the complication group (n = 55), wire breakage (n = 21, 38.18%) and bar displacement (n = 10, 18.18%) were the most frequent complications. Twenty-two (15.71%) patients required a second procedure. Recurrences have been reported in four of twelve techniques. There were no lethal outcomes.
Conclusions
MARPC techniques are not standardized, as MIRPE are, so comparative analysis is difficult as the only common denominator is minimal access. Surgical morbidity is high in MARPC and affects > 2/3rd patients with about 15% requiring surgery for complication management.