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Customized Two-Dimensional Computed Tomography-Guided Preoperative Pectus Bar Shaping.

Christopher Wei Guang Ho¹, Bien-Keem Tan¹, Boon Hean Ong²

¹From the Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital.

Annals of Plastic Surgery

|June 28, 2021

Summary

This summary is machine-generated.

This study introduces a new method for pectus excavatum repair using computed tomography (CT) scans to pre-shape pectus bars. This technique simplifies surgery and improves patient outcomes for chest wall deformities.

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Area of Science:

Thoracic surgery
Medical imaging
Biomechanical engineering

Background:

Minimally invasive repair of pectus excavatum requires precise pectus bar shaping for optimal sternal elevation.
Current intraoperative bar shaping is time-consuming and risks iatrogenic injury.

Purpose of the Study:

To present a novel technique for preoperative pectus bar shaping using life-sized computed tomography (CT) printouts.
To evaluate the efficacy and patient satisfaction with this CT-guided approach for pectus excavatum repair.

Main Methods:

A life-sized CT printout of the patient's chest wall was used as a template for preoperative pectus bar bending.
The technique involved using a polymethylmethacrylate block as a scaling marker during CT acquisition.
Thirty patients underwent minimally invasive repair using the pre-shaped pectus bar.

Main Results:

All 30 patients achieved satisfactory sternal elevation with a single bar insertion.
No intraoperative bar revisions were needed.
Patients reported high satisfaction with aesthetic (4.6/5) and functional (4.4/5) improvements, with an overall satisfaction score of 4.7/5.

Conclusions:

CT-guided preoperative pectus bar shaping is a straightforward and effective method for correcting pectus excavatum.
This technique minimizes intraoperative manipulation and improves patient outcomes.
High levels of aesthetic and functional satisfaction were achieved in all patients.