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[The results of the Ravitch-Sutherland technic for surgical correction in pectus excavatum]
D G Goţia1, S G Aprodu, B Savu
1Facultatea de Medicină, Clinica de chirurgie şi ortopedie pediatrică Iaşi, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi.
Insights
The modified Ravitch-Sutherland procedure effectively treats pectus excavatum in children, yielding excellent functional and cosmetic outcomes. This surgical technique offers lasting results for chest wall deformities.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Malformations
Context:
- Pectus excavatum is a congenital chest wall deformity affecting children.
- Surgical intervention is often necessary for functional impairment or cosmetic concerns.
- The Ravitch-Sutherland procedure is a known surgical approach for pectus excavatum.
Purpose:
- To evaluate the functional and cosmetic results of a modified Ravitch-Sutherland procedure in pediatric patients with pectus excavatum.
- To assess the long-term efficacy and safety of this surgical modification.
Summary:
- A modified Ravitch-Sutherland procedure was performed on 31 children (ages 5-16) with pectus excavatum.
- Modifications included omitting perichondral plicature and adding diaphragmatic elongation and laparoplasty.
- Good functional and cosmetic results were achieved in all cases, with successful management of recurrences.
Impact:
- The modified Ravitch-Sutherland procedure is an effective treatment for pectus excavatum.
- This technique provides satisfactory long-term functional and aesthetic improvements.
- The study highlights a valuable surgical option for pediatric chest wall deformities.
Abstract:
The aim of our study was to assess the functional and cosmetic results after performing a modified Ravitch-Sutherland procedure in children presenting with excavatum. A series of 31 children with ages ranging between 5 and 16 years, presenting with pectus excavatum, were operated between 1986-1996 in our service. In 5 cases surgical treatment was required by the presence of respiratory and/or cardiac functional impairment due to the malformation. In the other 23 cases operation was performed mainly for cosmetic reasons. In all cases a modified Ravitch-Sutherland procedure was performed. Modification consisted in renouncing at the plicature of the perichondra and in associating a diaphragmatic elongation and Bedouelle laparoplasty in all cases. Longitudinal sternotomy was performed in 2 cases with severely impaired ventilatory capacity. Functional and cosmetic results were good in all cases. In 2 cases, in which recurrence of the condition was observed, a second identical procedure was performed, with a good result. The interval between the operation and the moment of long-term evaluation ranged between 3 months and 11 years. We conclude that the modified Ravitch-Sutherland procedure represents an effective method for the treatment of pectus excavatum cases, offering good functional and cosmetic long-term results.