Does Costal Cartilage Resection Reduce Lung Volume ? (An Experimental Stereological Study)

Abstract

Background: Surgical treatment of chest wall deformities is done with costal cartilage resection in selected patients in adolescence. In this study, we evaluated the effect of costal cartilage resections on the lung volume by using computed tomography with stereologically. Methods: In this study, sixteen 4-weeks-old New Zealand rabbits were employed. Young subjects were preferred to evaluate the effect of the operation on the growth process. In order to avoid postoperative complications, only 2 costal cartilage resection was performed. The surgical group was resected to the right 4 and 5 costal cartilages (n = 8). The group that was not operated was accepted as the control group (n=8). The growth of the subjects was followed. Computed thorax tomography (CTT) scans of all animals were performed preoperatively and at the 4th postoperative week. Estimation of pre- and postoperative lung volumes was performed with the Cavalieri principle. Results: In the control group followed up during growth, bilateral lung volume was increased (15.75% and 20.62% respectively right and left lungs). In the surgical group, both the surgical side and the opposite lung volume decreased after costal cartilage resection (20.09% and 1.07% respectively right and left lungs). Conclusions: Even though the number of resected cartilage was limited, total lung volume decreased after costal cartilage resection. In the treatment of chest wall deformities, costal cartilage resection should be considered as the last option in children.

Keywords

• Pectus excavatum
• Cavalieri principal
• Costal cartilage
• Lung

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