Recent Advancements in Pectus Surgery: Crane Lifting, Multiple-Bar Approach, Bridge Stabilization, and Sandwich...

Area of Science:

• Thoracic surgery
• Pediatric surgery
• Surgical innovation

Background:

• Pectus excavatum is a congenital chest wall deformity.
• Traditional repair methods have limitations.
• A novel crane-powered remodeling technique has emerged.

Purpose of the Study:

• To evaluate the efficacy and safety of crane-powered entire chest wall remodeling for pectus excavatum repair.
• To assess the impact of this technique on chest wall anatomy and patient outcomes.

Main Methods:

• Retrospective analysis of 649 patients undergoing pectus excavatum repair (March 2018 - January 2022).
• Utilized crane lifting with sternal wiring/screwing, multiple bars with bridge connections, and modified sandwich techniques.
• Focused on resolving lower coastal flare and focal protuberance.

Main Results:

• Mean patient age was 12.2 years (range 3-45).
• Multiple bar configurations (parallel, crossbars, XI pattern) were employed.
• Overall complication rate was 6.2%, with no bar displacement; minor complications included pneumothorax (3.1%) and wound infection (0.8%).
• Three patients required reoperation.

Conclusions:

• Crane-powered entire chest wall remodeling enhances safety and comprehensiveness in pectus excavatum repair.
• Bridge stabilization and multiple bars effectively prevent bar displacement and incomplete repair.
• This technique represents a significant advancement in pectus deformity correction.