• Experience of surgical treatment of pectus excavatum in children
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Experience of surgical treatment of pectus excavatum in children

PAEDIATRIC SURGERY.UKRAINE.2018.1(58):81-84; doi 10.15574/PS.2018.58.81

Digtyar V. A., Kaminska M. O., Moxov A. I., Koval S. V.
SI «Dnіpropetrovsk Medical Academy of Health Ministry of Ukraine», Dnipro
CI «Dnipropetrovsk Regional Children’s Clinical Hospital of the Dnipro Regional Council», Dnipro, Ukraine

Pectus excavatum is the most common thoracic wall deformities. This anomaly manifests itself as a cosmetic defect as well as cardiovascular and respiratory functional disorder. Its characteristic feature is the tendency towards progression, which is closely related to the child’s growth and age.
Objective – a comparative characteristic of the retrosternal and thoracoscopic control of metal struts conduction during thoracoplasty of pectus excavatum (PE) according to D. Nuss.
Material and methods. There 50 children aged from 4 to 17 years with PE were examined and treated. The symmetrical form of deformation was observed in 33 (66%) patients, asymmetric – in 10 (20%) cases, and flat-shaped – in 7 (14%) children. Preoperative examination included general clinical lab tests, spirography, electrocardiography, echocardiography, chest X-ray examination in direct and lateral projections, and computed tomography. All patients underwent thoracoplasty according to D. Nuss.
Results. All patients were followed up after the surgery to observe surgical outcomes. Good results were obtained in 43 (86%) cases, satisfactory – in 6 (12%) children, and unsatisfactory outcome was in 1 (2%) patient.
Conclusions. Surgical correction of PE by using retrosternal metal struts is a perspective direction of thoracoplasty, which has advantages over resection techniques (minimally invasive with good cosmetic outcomes), and thoracoscopic technique increases safety and reduces the traumaticity of surgical intervention.
Key words: pectus excavatum, thoracoplasty, children.


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