Protrusion and mixed deformities.

Area of Science:

• Thoracic surgery
• Pediatric surgery
• Plastic and reconstructive surgery

Background:

• Classification and surgical repair of anterior chest wall deformities are challenging, particularly for asymmetric types.
• Asymmetric deformities are often arbitrarily categorized as either impressions or protrusions, leading to confusion.

Purpose of the Study:

• To present a standardized surgical technique for correcting mixed and severe funnel chest deformities.
• To evaluate the efficacy and safety of this surgical approach using the pectus index.

Main Methods:

• A surgical technique involving double subperichondral excisions of distorted cartilages and subperiosteal wedge incision of bony segments was employed.
• A T-shaped sternal incision and a stainless steel stabilizer were used to maintain the corrected position.
• The study included 420 operations, with specific focus on 89 pure protrusions and 64 mixed deformities.

Main Results:

• The surgical method was successfully applied to 60 patients with mixed or severe funnel chest deformities without complications.
• The pectus index, a measure of chest wall deformity severity, significantly improved post-surgery.
• Preoperative pectus index of 53+/-7.6% decreased to 44.2+/-6.3% (p<0.05) in 63 followed patients.

Conclusions:

• The described surgical technique is effective and safe for correcting mixed and severe anterior chest wall deformities.
• The use of a stainless steel stabilizer aids in maintaining the corrected position post-surgery.
• The pectus index serves as a reliable indicator for assessing the outcomes of surgical correction.