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Repair of Pectus Excavatum Deformities in Children
A New Perspective of Treatment Using Minimal Access Surgical Technique
Peter C. Wu, MD;
Eric M. Knauer, MD;
George E. McGowan, MD;
Donald W. Hight, MD
Arch Surg. 2001;136:419-424.
Hypothesis Minimally invasive correction of pectus excavatum (PE) deformities of the anterior chest wall in children is safe and effective.
Design Prospective cohort study.
Setting Tertiary pediatric referral center.
Patients Between February 1996 and July 2000, 36 patients underwent minimally invasive repair (MIR) of PE deformities, and 6 patients had traditional Ravitch repairs (RR).
Main Outcome Measures Morbidity, operating time, estimated blood loss, days to tolerating a regular diet, and length of hospital stay.
Results Thirty-six children underwent MIR for moderate to severe chest wall deformities, with a mean operative time of 1.6 hours, a mean blood loss of 22 mL, a mean time to tolerating a regular diet of 2.9 days, no intensive care unit admissions, and a mean length of hospital stay of 5.5 days. Six children had RR procedures performed for moderate to severe deformity, with a mean operative time of 5.2 hours, a mean blood loss of 222 mL, a mean time to tolerating a regular diet of 3.3 days, 2 patients admitted to the intensive care unit, and a mean length of hospital stay of 4.5 days. Complications for both procedures consisted mainly of postoperative pneumothorax.
Conclusions The MIR technique for PE is less invasive, less morbid, and better tolerated than traditional open RR of this common pediatric chest wall deformity. Elective surgical reconstruction can be safely performed in children rather than limiting repair to only symptomatic patients with severe deformities.
From the Department of Surgery, University of Connecticut Health Center, Farmington (Drs Wu and Knauer), and the Department of Pediatric Surgery, Connecticut Children's Medical Center, Hartford (Drs Gowan and Hight).
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