Simplified open repair for anterior chest wall deformities. Analysis of results in 205 patients - 06/04/12

Doi : 10.1016/j.otsr.2011.11.005

A. Wurtz ^a,^⁎ , N. Rousse ^a, L. Benhamed ^a, M. Conti ^b, I. Hysi ^a, C. Pinçon ^c, R. Nevière ^d
^a Thoracic and Cardiac Surgery Division, Albert Calmette Hospital, Lille University Teaching Hospital, 59037 Lille cedex, France
^b Thoracic Surgery Department, IUCPQ (Laval Hospital, Québec), Québec, Canada
^c Biostatistics Department, EA 2694, UDSL, University of Lille - North of France, 59006 Lille, France
^d Respiratory function evaluation laboratory, Albert Calmette Hospital, Lille University Teaching Hospital, 59037 Lille cedex, France

Corresponding author. Tel.: +33 3 20 44 45 59; fax: +33 3 20 44 48 90.

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Summary

Introduction

Pectus deformities are the most frequently seen congenital thoracic wall anomalies. The cause of these conditions is thought to be abnormal elongation of the rib cartilages. We here report our clinical experience and the results of a sternochondroplasty procedure based on the subperichondrial resection of the elongated cartilages.

Hypothesis

This technique is a valuable surgical strategy to treat the wide variety of pectus deformities.

Patients and methods

During the period from October 2001 through September 2009, 205 adult patients (171 men and 34 women) underwent pectus excavatum (181), carinatum (19) or arcuatum (5) repair. The patients’ pre and postoperative data were collected using a computerized database, and the results were assessed with a minimum 2-year follow-up.

Results

The postoperative morbidity rate was minimal and the mortality was nil. The surgeon graded cosmetic results as excellent (72.5%), good (25%) or fair (2.5%), while patients reported better results. Patients with pectus excavatum were found to have much more patent foramen ovale (PFO) than the normal adult population, which occluded after the procedure in 61% of patients, and significant improvement was found in exercise cardiopulmonary function and exercise tolerance at the 1-year follow-up.

Discussion

Our sternochondroplasty technique based on the subperichondrial resection of the elongated cartilages allows satisfactory repair of both pectus excavatum and sternal prominence. It is a safe procedure that might improve the effectiveness of surgical therapy in patients with pectus deformities.