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Surgery of chest wall deformities

A C de Matos1, J E Bernardo, L E Fernandes

  • 1Serviço de Cirurgia Cardiotorácica, Hospitais da Universidade, Coimbra, Portugal.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|October 23, 1997
PubMed
Summary

Surgical correction of chest wall deformities, including pectus excavatum and pectus carinatum, yields excellent medium-term outcomes. The modified technique improved physical function and patient satisfaction, supporting its use across various ages.

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Area of Science:

  • Thoracic surgery
  • Pediatric surgery
  • Skeletal deformities

Background:

  • Chest wall deformities affect physical function and psychological well-being.
  • Pectus excavatum and pectus carinatum are common types requiring surgical intervention.
  • Previous surgical techniques had variable outcomes.

Purpose of the Study:

  • To evaluate the medium-term results of a modified surgical technique for chest wall deformities.
  • To assess functional, cosmetic, and psychological outcomes in operated patients.

Main Methods:

  • A cohort of 77 patients (53 pectus excavatum, 24 pectus carinatum) underwent surgery between 1985 and 1994.
  • The modified technique involved subperichondrial resection of abnormal costal cartilages, sternal osteotomies, and internal steel rod stabilization.

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  • Patients were followed up for medium-term results, with a mean age of 14.7 years.

    • Main Results:

    • No mortality was observed. One patient experienced pneumothorax requiring drainage.
    • 90% of patients reported increased effort tolerance, and 72% with asthmatic symptoms showed reduced crisis frequency.
    • 97.3% of patients were satisfied with the cosmetic results; psychological disturbances were significantly reduced.

    Conclusions:

    • The modified surgical technique provides good cosmetic, orthopedic, and psychological results for chest wall deformities.
    • The procedure is effective across different age groups, particularly for moderate to severe deformities.
    • This approach is recommended for surgical correction of pectus excavatum and pectus carinatum.