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Mechanism of pulmonary function changes after surgical correction for funnel chest
L Derveaux1, I Ivanoff, F Rochette
1Clinic of Lung Disease, University Hospitals, Catholic University, Leuven, Belgium.
The European Respiratory Journal
|October 1, 1988
Summary
Corrective surgery for pectus excavatum significantly reduces lung function. Post-surgery chest wall mechanics, not lung issues, cause this restrictive defect, impacting vital capacity and expiratory volume.
Area of Science:
- Thoracic surgery
- Pulmonary function testing
- Chest wall mechanics
Background:
- Pectus excavatum surgery can negatively impact ventilatory capacity.
- The exact cause of this ventilatory deficit (pulmonary vs. chest wall factors) remains unclear.
Purpose of the Study:
- To determine if reduced ventilatory capacity after pectus excavatum repair is due to pulmonary or chest wall factors.
Main Methods:
- Evaluated 24 patients with pectus excavatum undergoing corrective surgery.
- Assessed ventilatory capacity, vital capacity, forced expiratory volume in one second, and lung pressures (transpulmonary and transdiaphragmatic) preoperatively and postoperatively.
Main Results:
- Postoperatively, vital capacity decreased from 89% to 64% predicted (p < 0.001).
- Forced expiratory volume in one second decreased from 88% to 66% predicted (p < 0.001).
- Reduced transpulmonary and transdiaphragmatic pressures at total lung capacity indicated an extrapulmonary cause.
Conclusions:
- The restrictive ventilatory defect following pectus excavatum surgery is primarily caused by abnormal chest wall mechanics.
- Extensive sternal and parasternal surgery leads to impaired chest wall compliance, affecting lung function.