Minimally Invasive Pectus Excavatum Surgery: A Single Center Experience

Yıl 2021, Cilt: 12 Sayı: 42, 18 - 22, 15.04.2021

Ahmet Acıpayam Mahmut Tokur

https://doi.org/10.17944/mkutfd.833764

Öz

Abstract
Minimally Invasive Pectus Excavatum Surgery: A Single Center Experience.

Aim: Pectus Excavatum (PE) is the most common chest wall deformity. PE is seen once in 300-400 live births. Although there are many methods in the surgical treatment of PE, the most common approach is the Nuss method, which aims to correct the deformity by placing a metal bar under the sternum. In this study, we aimed to present the results of Nuss operations we performed in our clinic in the light of the literature.
Materials and Methods: The data of 20 patients who underwent Nuss operation for PE between August 2011 and December 2019 in our clinic were retrospectively analyzed.
Results: Eighteen of the patients were male and 2 were female. The age distribution of the patients we operated on was between 6 and 17 years and the median age was 15. The indication for the operation in patients was cosmetic reasons. Average length of hospital stay was 7 days (range 3-15 days). 95% of the patients stated that they were satisfied with the result due to the improvement of the deformity after the operation.
Conclusion: Nuss operation, which is a minimally invasive procedure for PE, increases patient satisfaction due to its shorter operation time, smaller incision scar and more aesthetic appearance.
Keywords: Pectus excavatum, Nuss Operation, Chest Deformity

Anahtar Kelimeler

Pectus excavatum, Nuss Operation, Chest Deformity

Minimal İnvaziv Pektus Ekskavatum Ameliyatı: Tek Merkez Deneyimi

Öz

ÖZ
Minimal İnvaziv Pektus Ekskavatum Ameliyatı: Tek Merkez Deneyimi
Amaç: Pektus Ekskavatum (PE), en sık görülen göğüs duvarı deformitesidir . PE 300-400 canlı doğumda bir görülür. PE’un cerrahi tedavisinde birçok yöntem bulunmakla birlikte en sık kullanılan yaklaşımlar sternum altına metal bir bar yerleştirilerek deformiteyi düzeltmeyi amaçlayan Nuss yöntemidir. Bu çalışmada kliniğimizde gerçekleştirdiğimiz Nuss operasyonlarının sonuçlarını literatür eşliğinde sunmayı amaçladık.
Gereç ve Yöntem: Ağustos 2011-Aralık 2019 tarihleri arasında kliniğimizde PE nedeniyle Nuss operasyonu uygulanan 20 hastanın verileri retrospektif olarak incelendi.
Bulgular: Hastaların 18’i erkek 2’si kadındı. Opere ettiğimiz hastaların yaş dağılımı 6 ile 17 yaş arasında olup ortanca yaş 15 idi. Hastalarda operasyon için endikasyon kozmetik sebepler idi. Ortalama hastanede yatış süresi 7 gün (dağılım 3-15 gün) idi. Hastaların %95’i operasyon sonrası deformitenin düzelmesine bağlı sonuçtan memnun olduğunu ifade ettiler.
Sonuç: PE için yapılan minimal invaziv girişim olan Nuss operasyonu daha kısa operasyon süresi, daha küçük insizyon skarı ve daha estetik görünmesi nedeniyle hasta memnuniyetini arttırmaktadır.
Anahtar Kelimeler: Pektus ekskavatum, Nuss Operasyonu, Göğüs Deformitesi

Anahtar Kelimeler

pektus ekskavatum, nuss operasyonu, göpüs deformitesi

Kaynakça

• Huddleston CB. Pectus excavatum. Semin Thorac Cardiovasc Surg 2004;16:225-32. https://doi.org/10.1053/j.semtcvs.2004.08.003
• Tokur M. Pektus karinatum ve iki taraflı servikal kosta anomalisi: Olgu sunumu [Pectus carinatum and bilateral cervical costa labnormality: a casereport] Türk Göğüs Kalp Damar Cerrahisi Dergisi 2012;20(4):951-953. doi: 10.5606/tgkdc.dergisi.2012.190 https://doi.org/10.5606/tgkdc.dergisi.2012.190
• Schamberger RC. Chest wall deformities. In Shields TW,Locicero III J, Reed CE, FeinsRH,eds. General Thoracic Surgery, 7th ed. Philadelphia: Lippincott Williams &Wilkins. 2009:599.
• Waters PM, Welch K, Micheli LJ, Shamberger R, Hall JE. Scoliosis in children with pectus excavatum and pectus arinatum. J Pediatr Orthop 1989;9:551-6. https://doi.org/10.1097/01241398-198909010-00009
• Shamberger RC, Welch KJ. Surgical Repair of Pectus Excavatum. J Pediatr Surg 1988;23:615-22. https://doi.org/10.1016/S0022-3468(88)80629-8
• Bostancı K, Yüksel M. Minimal invaziv pektus ekskavatum düzeltme ameliyatı: teknik ve uygulama, marmara deneyimi. Toraks Cerrahisi Bülteni 2011;2:196-203. https://doi.org/10.5152/tcb.2011.30
• Nuss D, Kelly RE Jr, Croitoru DP, Katz ME. A 10-year review of a minimally invasiv etechnique for the correction of pectus excavatum. J Pediatr Surg 1998;33:545-52. https://doi.org/10.1016/S0022-3468(98)90314-1
• Nuss D. Minimally invasiv e surgical repair of pectusexcavatum. Semin Pediatr Surg 2008;17:209-17. https://doi.org/10.1053/j.sempedsurg.2008.03.003
• Demirkaya A, Şimşek F, Erşen E, Aksoy B, Sayılgan C,Turna A ve ark. Pektus eskavatumun minimal invazif olarak düzeltilmesinde komplikasyonları belirleyen faktörler. Turk Gogus Kalp Dama 2011;19:201-6. https://doi.org/10.5606/tgkdc.dergisi.2011.013
• Blanco FC, Elliott ST, Sandler AD. Management of Congenital Chest Wall Deformities. Semin Plast Surg 2011; 25: 107-16. https://doi.org/10.1055/s-0031-1275177
• Tokur M, Demiröz ŞM, Sayan M, Tokur N, Arpağ H. Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature. Curr Thorac Surg. 2016; 1(1): 021-027 https://doi.org/10.26663/cts.2016.0005
• Chung CS, Myrianthopoulos NC. Factors affecting risks of congenital malformations. I.Analysis of epidemiologic factors in congenital malformations. Report from the Collaborative Perinatal Project. Birth Defects Orig Artic Ser 1975; 11: 1-22.
• Nuss D, Kelly RE. Indication sand technique of nuss procedure for pectus excavatum. Thoracic Surgery Clinics 2010;20: 583-97. https://doi.org/10.1016/j.thorsurg.2010.07.002
• Özalper MH, Yüksel M. Göğüs duvarı deformiteleri. Turkiye Klinikleri J Thor Surg- Special Topics 2011; 4(2): 130-3.
• Tokur M. Poland syndrome accompanied by isolated dextrocardia and scoliosis: a case report. Turkish Journal of Thoracic and Cardiovascular Surgery 2013:21(1):201-203. https://doi.org/10.5606/tgkdc.dergisi.2013.3928
• Sigalet DL, Montgomery M, Harder J, Wong V, Kravarusic D, Alassiri A. Long term cardio pulmonary effects of close drepair of pectus excavatum. Pediatr Surg Int 2007; 23:493-7. https://doi.org/10.1007/s00383-006-1861-y
• Bawazir OA, Montgomery M, Harder J, Sigalet DL. Mid term evaluation of cardio pulmonary effects of close drepair for pectus excavatum. J Pediatr Surg 2005; 40: 863-7. https://doi.org/10.1016/j.jpedsurg.2005.02.002
• Pawlak K, Gasiorowski Ł, Gabryel P, Gałecki B, Zielinski P, Dyszkiewicz W. Early and late results of the Nuss procedure in surgical treatment of pectus excavatum in different age groups. Ann Thorac Surg 2016; 102: 1711-6. https://doi.org/10.1016/j.athoracsur.2016.04.098
• Hanna WC, Ko MA, Blitz M, Shargall Y, Compeau CG.Thoracoscopic Nuss procedure for young adults with pectus excavatum: excellent midterm results and patient satisfaction. AnnThoracSurg 2013;96:1033-6. https://doi.org/10.1016/j.athoracsur.2013.04.093
• Pilegaard HK, Licht PB. Routineuse of minimally invasiv esurgery for pectus excavatum in adults. Ann Thorac Surg 2008;86:952-6. https://doi.org/10.1016/j.athoracsur.2008.04.078
• Abramson H, Abramson L. Minimally access repair of pectus carinatum. In: Saxena AK, editor. Chest wall deformities. Berlin Heidelberg: Springer-Verlag; 2017:545-69. https://doi.org/10.1007/978-3-662-53088-7_47
• Lee SY, Song IH, Lee SJ. Minimal invasive extrathoracic presternal compression using a metal bar for correction of pectus carinatum. Pediatr Surg Int 2014; 30:25-30. https://doi.org/10.1007/s00383-013-3419-0
• Önen A, Şanlı A, Eyüboğlu GM, Gökçen KM, Karaçam V. Minimal invaziv teknik uygulanan pektus ekskavatumlu olgularda erken dönem memnuniyet bildirimi. Türk Göğüs Kalp Damar Cer Derg 2008;16:113-7.