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Pectus carinatum treatment in Canada: current practices
Sherif Emil1, Jean-Martin Laberge, David Sigalet
1Division of Pediatric General Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. Sherif.Emil@McGill.ca
Journal of Pediatric Surgery
|May 19, 2012
Summary
Canadian pediatric surgeons prefer bracing for pectus carinatum (PC) treatment. Most surgeons use bracing as the primary method, viewing it as superior to surgery, despite limited outcome data.
Area of Science:
- Pediatric Surgery
- Thoracic Wall Deformities
Background:
- Pectus carinatum (PC) is a chest wall deformity with various treatment options.
- Current practices among Canadian pediatric surgeons for PC correction were not well-defined.
Purpose of the Study:
- To survey Canadian pediatric surgeons and define their current practices for pectus carinatum evaluation and treatment.
- To specifically assess the role and perceived effectiveness of bracing in PC management.
Main Methods:
- An online survey was distributed to active members of the Canadian Association of Paediatric Surgeons in winter 2011.
- The survey covered PC evaluation, treatment modalities, and detailed aspects of bracing practices.
Main Results:
- 85% of surgeons responded, with 71% actively treating PC; 53% manage low-volume practices (<5 patients/year).
- Bracing was the most common treatment (69%), preferred over Ravitch repair (25%) and other surgical methods.
- Surgeons using bracing reported good to excellent results (57%) and high patient satisfaction (74%), with strong agreement that bracing is preferable and should be first-line treatment.
Conclusions:
- Bracing is the predominant treatment choice for pectus carinatum among Canadian pediatric surgeons.
- Despite widespread use and perceived efficacy, there is a lack of prospective outcome data for bracing.
- A multicenter prospective study is recommended to establish evidence-based outcomes for PC bracing.
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