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Results for “Pectus Carinatum”

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PubMed1993

[Surgical treatment of pectus excavatum and pectus carinatum].

The authors present their experience with surgery of deformities of the chest wall in childhood. In the course of 1986 to 1992 they operated 93 children with the diagnosis of pectus excavatum. This number comprised 66 boys and 27 girls. The mean age of the operated children was 10.5 years. During the same period 17 patients (12 boys and 5 girls) were operated on account of pectus carinatum. The mean age of the latter group of patients was 13.5 years. 23% of the patients with a pectus excavatum had before operation mild scoliosis, two patients suffered from severe scoliosis. 76 patients after operation of pectus excavatum were followed up for more than one year after operation. In 44 patients the result was excellent (58%), in 31 patients the result was good. One patient developed a relapse. Fifteen patients after operation for pectus carinatum were followed up for more than one year. In 12 patients (80%) the result of the operation is excellent, in three patients (20%) the result is good. From the group as a whole seven patients had dehiscence of the wound after surgery, four patients developed a seroma in the surgical wound, three patients developed pneumothorax after operation and in one instance an abscess developed in the surgical wound. In the course of 1987 the authors changed the surgical technique in pectus excavatum from Jensen's to Holcomb jun. operation.

Adolescent↗

PubMed2004

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.

Adult↗

PubMed2002

[Technical refinements in planning and surgical therapy of pectus carinatum].

From 1998 to 2002 ten patients underwent surgical correction of pectus carinatum using a new diagnostic preoperative three-dimensional volume rendering mode computed tomography. Particularly the deformed rib cartilages can now also be visualized, which allows exact preoperative planning of the extent of cartilage resection and localization of required sternum osteotomies. This additional information results in a focused surgical approach and hence minimizes scars. As an additional innovation, resorbable plates and screws were used for refixation of the osteotomized parts of the sternum. For postoperative thorax immobilization and hypertrophic scar circumvention, a special keel chest brace was applied in all patients for 6-8 weeks. No complications occurred in any case, and all patients were very content with the aesthetic results achieved.

Absorbable Implants↗

PubMed2006

Nonoperative management of pectus carinatum.

BACKGROUND: Although surgery has been the mainstay of treatment of chondrogladiolar pectus carinatum (PC), several authors have advocated the benefits of nonoperative approaches to induce chest wall remodeling. Based on our initial success with compression bracing, we have integrated this modality into our treatment algorithm. METHOD: We reviewed the charts of all patients treated for PC at our pediatric hospital between 1997 and 2004. Patients were managed with observation, operative repair, and orthotic bracing that provides continuous anteroposterior sternal compression. The brace was worn for 14 to 16 hours per day until linear growth was complete or for a minimum of 2 years. RESULTS: One hundred patients were diagnosed with PC. Fifty-seven patients had no treatment and were monitored. Twenty-nine patients were fitted with a brace. Of these 29 patients, 3 were noncompliant, resulting in a compliance rate of 90%. Of the remaining brace patients, all have had positive outcomes with no observed complications. Seventeen patients underwent surgical repair. Their outcomes were also positive with no major complications. CONCLUSION: Our findings clearly demonstrate that compression bracing is a safe and effective treatment for children with chondrogladiolar PC. We currently offer this approach as a first-line treatment, reserving surgery for patients who are noncompliant and those who fail the nonoperative modality.

Adolescent↗

PubMed1958

[A new model of the apparatus for the treatment of pectus carinatum].

Explore the source record for details and available documents.

Humans↗

PubMed1980

Peculiar face, pectus carinatum and joint laxity in brother and sister.

This report describes a probably new syndrome seen in a brother and sister and characterized by joint laxity, pectus carinatum and a peculiar face with mild frontal bossing, low nasal bridge, lateral displacement of the inner malar hypoplasia, parrot-like nose, chubby cheeks, striking philtrum and arched upper lips.

Abnormalities, Multiple↗

PubMed1995

Iatrogenic pectus carinatum. A case report.

A boy underwent cardiac surgery when he was 27 months old; prior to that his anterior chest wall had been normal. He later developed a progressive pectus carinatum deformity. Thoracic surgeons are cautioned to be mindful of the sternal and costal growth plates in any surgical approach to intrathoracic structures. Special care is needed when such deformities are corrected in children and adolescents.

Child↗

PubMed2002

Giant intrathoracic extrapulmonary hydatid cyst manifested as unilateral pectus carinatum.

Liver and lung are the most common sites of hydatid disease, but it can also be seen elsewhere in the body. Extrapulmonary intrathoracic location of the disease is rare. This case of giant intrathoracic extrapulmonary hydatid cyst manifested as unilateral pectus carinatum serves to illustrate that hydatid disease can produce various symptoms and that it may also exist in locations apart from lung and liver.

Child↗

PubMed1998

[Thoracic epidural analgesia in the postoperative period of pediatric surgery for the repair of pectus excavatum and pectus carinatum].

To assess thoracic analgesia by continuous infusion in surgery to repair pectus excavatum and carinatum in children. This prospective study enrolled 14 children aged 6 to 14 years old scheduled for surgery to correct pectus excavatum and carinatum. After induction of general anesthesia, the T8-T9 epidural space was accessed and a catheter was inserted to T3-T7 with radioscopic monitoring. A loading dose of 0.03-0.04 ml/kg per segment to be blocked (5 segments: T3-T8) of 0.125% bupivacaine and 3 micrograms/ml fentanyl was given to children under 7 years of age; a dose of 0.02-0.03 ml/kg per segment was administered to children over the age of 7 years. A continuous perfusion of 0.1-0.4 ml/kg/h was maintained, with the possibility of additional boluses of 1 ml at 20 min intervals during surgery and the first three days thereafter. An intraoperative bolus was given when the level of blockade was not reached or when mean blood pressure and heart rate increased 15% over baseline. Pain relief was assessed on a numerical scale of 0 to 5 or on a scale of facial icons, depending on the patient's age. During the postoperative period, the pediatric ICU nurse administered a bolus if pain was [symbol see text]3 or heart rate increased 75% over age-based reference values. Top-up analgesia was provided with Metamizole at a dose of 25 mg/kg. No complications attributable to the technique or to sympathetic blockade were observed. All tubes were removed in the operating room. The thoracic epidural catheter was left in place for 70.3 +/- 2.6 h. Mean initial doses of analgesia were 0.45 microgram/kg of fentanyl and 0.2 mg/kg of bupivacaine. The mean number of complementary boluses was 3 +/- 1 during surgery, 5 +/- 2 on the first postoperative day and 4 +/- 1 on the second day. No patient required top-up analgesia on the third day. Hemodynamic stability during surgery and the postoperative period was good. Analgesia was excellent (< 2) for 78.5% of the patients on the first day after surgery, for 85.7% on the second day and for all patients on the third day. We recorded one case of pruritus (7.1%), three of nausea (21.4%) that subsided when butorphanol was given epidurally (20 micrograms/kg), and two cases of light sedation. Thoracic epidural analgesia is effective for alleviating postoperative pain from corrective thoracic surgery in children. Side effects were minimal and no anesthetic complications were observed.

Adjuvants, Anesthesia↗

PubMed1961