RESULTS OF SURGICAL TREATMENT OF PECTUS EXCAVATUM IN CHILDREN AND ADOLESCENTS.

Abstract

Congenital pectus excavatum (PE) takes the first place among the deformation of the chest, accompanied by violations of the cardiorespiratory system and various cosmetic defects. A radical way to eliminate the deformation of the chest is surgical correction-thoracoplasty.

Material and methods: This study was performed on the results of surgical treatment of 183 patients with various forms of PE at the age of 3 to 18 years. All operated children were divided into three groups. The first group consisted of 76 (41.5%) patients who underwent thoracoplasty with fixation of the mobilized sternal-rib complex on an external traction splint. The second group included 77 (42,1%) patients operated by the developed method of thoracoplasty. The third group of 30 (16.4%) patients operated on the classical Nuss-method. Short- and long-term results were compared between the groups.

Results: The operation time was significantly shorter in third group (55 min) and the volume of blood loss was higher in the first group (46,4±12,5 ml). Pleural effusion and atelectasis were observed 4 and 3 patients and atelectasis, or pneumonitis was observed 3 and 2 patients in first and third groups respectively. The duration of postoperative pain syndrome was significantly shorter in second group with intercostal blockade. Pneumothorax was established 4 and 3 patients in first and third groups. Partial relapse and complete relapse were observed 3 (4.1%) and 2 (2.7%) patients in the first group.

Conclusion: Short and long-term results were excellent for modified thoracoplasty and Nuss procedures with low complication rates.