Surgical treatment of chest deformities
Хирургическое лечение деформаций грудной клетки
Azat Satzhanov 1, Marat Rabandiyarov 1, Bolat Nagimanov 2
More Detail
1 Zhambyl Regional Children’s Hospital
2 Corporate fund “University Medical Center” National Research Center for Maternal and Child Health, Astana, Kazakhstan
J CLIN MED KAZ, Volume 3, Issue 45 special issue, pp. 22-24.
https://doi.org/10.23950/1812-2892-JCMK-00509
OPEN ACCESS
3279 Views
2523 Downloads
ABSTRACT
The purpose of the study: evaluation of clinical outcomes after thoracoplastic operations, including D. Nass in children with various forms of chest deformities.
Methods: 28 thoracoplastic surgeries were performed on the basis of the Zhambyl Regional Children's Hospital from 2015, and 3 of them in cooperation with specialists from the UMC "NSMC". By sexual ratio, boys prevailed (1:3,6). According to the types of deformities 55.6% of the pectus excavatum, 21.4% of the Poland syndrome, 14% of the pectus carinatum. All the children underwent radiological studies: radiography, CT with the defnitions of the Gyzick and Haller indexes.
Results: Indication for an operative intervention with a funnel-shaped cosmetic defect of the chest, the Haller index is more than 3.25; the Gizyck index is less than 0.65. The average duration of operations was 56.39 ± 1.40 min, the time spent in the intensive care unit was 1.14 ± 0.12 days, and the time spent in the pediatric orthopedics department was 12.35 ± 1.15 days. Based on the results of IG in the pre-operative period averaged 0.59, after the operation the mean IG increased to 1.00, which shows a correction of the chest. Differences of IG in the preoperative and postoperative periods demonstrate an increase in the IG index by an average of 85.0% of the initial.
Conclusions: According to our observations, the results of D. Nass's operation under endovision, in the postoperative period, show good and satisfactory results to 85% of cases, with a low risk of complications. When fxing the plate, it is recommended to strictly observe the operating technique: epipleural implant insertion, blockage of the ends with short transverse plates, which contributes to the stability of the metal structure.
REFERENCES
- Jaroszewski D, Notrica D, McMahon L, Steidley DE, Deschamps C. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. J Am Board Fam Med. 2010;23(2):230–239. doi:10.3122/jabfm.2010.02.090234
- Nuss D, Obermeyer RJ, Kelly RE Jr, . Pectus excavatum from a pediatric surgeon's perspective. Ann Cardiothorac Surg. 2016;5:493–500. doi:10.21037/acs.2016.06.04
- Kelly RE Jr, Mellins RB, Shamberger RC, et al. Multicenter study of pectus excavatum, final report: complications, static/exercise pulmonary function, and anatomic outcomes. J Am Coll Surg. 2013;217(6):1080–1089. doi:10.1016/j.jamcollsurg.2013.06.019
- Jo WM, Choi YH, Sohn YS, Kim HJ, Hwang JJ, Cho SJ. Surgical treatment for pectus excavatum. J Korean Med Sci. 2003;18(3):360–364. doi:10.3346/jkms.2003.18.3.360
- Sacco Casamassima MG, Goldstein SD, Salazar JH, McIltrot KH, Abdullah F, Colombani PM. Perioperative strategies and technical modifications to the Nuss repair for pectus excavatum in pediatric patients: a large volume, single institution experience. J Pediatr Surg. 2014;49 (4): 575–582. doi:10.1016/j.jpedsurg.2013.11.058