• Comparison of conservative and surgical treatment of pectus carinatum in children

Comparison of conservative and surgical treatment of pectus carinatum in children

PAEDIATRIC SURGERY.UKRAINE.2018.3(60):18-29; doi 10.15574/PS.2018.60.18

Zaremba V. R., Danylov O. A., Shulga D. I., Dotsenko M. O., Kurochkin O. S.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
Communal Institution «Zhytomyr Regional Children’s Clinical Hospital» of Zhytomyr Regional Council, Ukraine
Communal Institution «Kryvyi Rih City Clinical Hospital No.8» of Dnipro Regional Council, Ukraine

An analysis of conservative treatment of 58 patients with pectus carinatum using a brace system of original design during the period of November 2015–June 2018 was conducted. In addition, the analysis of surgical treatment of 111 patients with pectus carinatum operated according to Abramson in the modification of D.I. Shulga was carried out. The patients were operated during the period of 2009-2018. In all cases of non-operative completed treatment, a recovery was achieved; all patients with incomplete conservative treatment had positive changes and treatment is continued. In one case a tendency to relapse was revealed, which required the а prolongation of treatment for 4 months. Certain advantages of the in-house design of the dynamic compression brace are noted. A similar brace was constructed for correcting the concomitant protrusion of costal arches; another brace was used for the first time for pectus carinatum correction in teenage girls and women. The first experience of the comprehensive simultaneous non-operative treatment of pectus carinatum, combined with severe kyphosis, scoliosis and kyphoscoliosis, was illuminated. The features, advantages of the anterior minimally invasive thoracoplasty according to Abramson-Shulga were noted. Good functional and cosmetic surgical results in all cases were achieved. The fixing arc – a plate of own design was proposed. The functional status of the cardiorespiratory system was analysed before and after the treatment. The comparative analysis of the conservative and surgical treatment results was made.

Key words: pectus carinatum, conservative treatment, minimally invasive surgical treatment, dynamic compression brace.

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Article received: Apr 04, 2018. Accepted for publication: Sep 15, 2018.