Bridge fixation provides consistent implant stability across surgical techniques: A multicenter study

Area of Science:

• Thoracic surgery
• Minimally invasive surgery
• Pediatric surgery

Background:

• Bar rotation is a significant complication after minimally invasive repair of pectus excavatum (MIRPE).
• This complication can necessitate reoperation and carries a risk of severe intrathoracic injury.
• Bridge fixation is a proposed method to enhance implant stability and prevent rotation, but evidence is limited.

Purpose of the Study:

• To evaluate the effectiveness of bridge fixation in preventing implant rotation.
• To assess the stability of bridge fixation in a large, multicenter patient cohort.

Main Methods:

• A retrospective multicenter study included 710 patients undergoing chest wall repair with intrathoracic implants stabilized by bilateral lateral bridges.
• Data collected included demographics, surgical techniques, implant configurations, cryoanalgesia use, length of stay, complications, and implant removal.
• The primary outcome was reoperation due to implant rotation.

Main Results:

• A total of 1,821 implants were analyzed across five centers.
• No cases of implant rotation requiring reoperation were observed.
• Postoperative complications requiring reoperation occurred in 6.1% of patients, but none were attributed to implant rotation.

Conclusions:

• Bridge fixation demonstrated complete prevention of implant rotation requiring reoperation in this large multicenter series.
• The technique proved reliable across diverse surgical approaches, implant types, and patient demographics.
• These findings support the use of bridge fixation to enhance implant stability in pectus excavatum repair.