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Pectus excavatum repair using autologous perichondrium for sternal support
Archives of Surgery (Chicago, Ill. : 1960)
|December 1, 1978
Summary
This study shows that using autologous perichondrium to support the lower sternum effectively prevents sternal depression after pectus excavatum repair in children. Internal prostheses may further benefit adolescents and adults, reducing recurrence rates.
Area of Science:
- Thoracic surgery
- Pediatric surgery
- Cardiothoracic surgery
Background:
- Pectus excavatum is a congenital chest wall deformity.
- Recurrent sternal depression can occur after surgical repair.
- The Ravitch repair is a standard surgical technique.
Purpose of the Study:
- To evaluate the effectiveness of autologous perichondrium in preventing sternal depression after pectus excavatum repair.
- To assess the benefits of internal prostheses for specific patient groups.
Main Methods:
- Autologous perichondrium from lower costal cartilages was used to supplement the Ravitch repair.
- The technique was applied to 29 children over 14 years.
- Internal prostheses were considered for adolescents, adults, and reoperation patients.
Main Results:
- Excellent cosmetic and functional results were achieved in 27 out of 29 children.
- Mild recurrent sternal depression occurred in two patients postoperatively, attributed to trauma or vascular supply issues, but required no further therapy.
- The technique demonstrated effectiveness in preventing significant sternal depression.
Conclusions:
- Autologous perichondrium provides effective support for the lower sternum in pectus excavatum repair, particularly in preadolescent children.
- Internal prostheses can be beneficial for older patients and reoperations to minimize sternal depression.
- Preservation of internal mammary vessels is recommended when feasible.