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Published on: May 4, 2022
[Minimally Invasive Technologies in Surgery of the Chest Wall in Children]
A Yu Razumovsky1,2, A B Alkhasov1,2, Z B Mitupov2
1Filatov State Children's Hospital, 123001, Moscow, Russia.
Insights
This study addresses the lack of standardized management for anterior chest wall deformities in children, including pectus excavatum, pectus carinatum, thoracic outlet syndrome, and sternum clefts. The developed techniques offer less invasive surgical correction, improving patient outcomes and quality of life.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Malformations
Background:
- Management of anterior chest wall deformities lacks a unified approach globally.
- Pediatric patients present with diverse conditions including pectus excavatum, pectus carinatum, thoracic outlet syndrome, and sternum clefts.
- Existing surgical methods are often traumatic, cosmetically concerning, costly, and require prolonged recovery.
Purpose of the Study:
- To present novel surgical techniques for correcting congenital anterior chest wall deformities in pediatric patients.
- To address the diagnostic and therapeutic challenges in pediatric thoracic outlet syndrome and sternum clefts.
- To improve patient quality of life through effective surgical interventions.
Main Methods:
- Development of specialized surgical techniques through interdisciplinary collaboration.
- Application of these techniques in treating pectus excavatum, pectus carinatum, thoracic outlet syndrome, and sternum clefts.
- Focus on minimizing patient trauma and improving cosmetic results.
Main Results:
- Successful surgical correction of various congenital chest wall malformations.
- Reduced invasiveness and improved postoperative cosmetic outcomes compared to traditional methods.
- Enhanced diagnostic and surgical care for complex pediatric thoracic conditions.
Conclusions:
- The developed multidisciplinary approach offers effective solutions for challenging pediatric chest wall deformities.
- These techniques provide a less traumatic and more cosmetically acceptable alternative for patients.
- Improved patient outcomes enable children to lead normal lives post-surgery.
Abstract:
Today, in our country, as well as throughout the world, there is no single approach to the tactics of managing patients with deformations of the anterior chest wall. These patients constitute a large and heterogeneous group. The team acquired great experience in treating children with pectus excavatum and pectus carinatum, as well as a unique experience in the surgical treatment of pediatric thoracic outlet syndrome and sternum clefts. Now in the world there are a lot of surgical methods used for the correction of congenital deformities of the chest wall, however, the majority of them are extremely traumatic for the patient, and the postoperative scar often presents a minor cosmetic problem than the deformation itself. In addition, almost all methods require the use of expensive technologies, the patient's long hospital stay and the use of potent drugs. As for the children with thoracic outlet syndrome and sternum clefts, these patients are extremely difficult in terms of timely diagnosis and surgical care, due to the fact that pediatric surgeons and pediatricians are very little aware of this pathology. The team of authors developed a number of techniques, based on the collaborative work of surgeons, anesthesiology and resuscitation specialists and pediatric services. They resulted in successful surgical correction of these malformations and gave patients the opportunity to lead a normal life.
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