Symmetrical excessive pectus excavatum in children
Asian Cardiovascular & Thoracic Annals 21(6) 683–688 ß The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492312467538 aan.sagepub.com
Akin Eraslan Balci1, Sevval Eren2 and Mehmet Oguzhan Ozyurtkan1
Abstract Objectives: The indications for repair of pectus excavatum are controversial. We present our surgical results in children with severe pectus excavatum. Methods: 27 children aged 6–15-years were included in the study. Pulmonary function tests and chest measurements were performed pre- and postoperatively. Deformed cartilages were resected subperichondrially, and a Kirchner wire was used to support the chest cage; it was removed 5 days after the operation. Fourteen children with restricted pulmonary function were considered to have excessive pectus excavatum. Results: 3 patients had asthma-like symptoms that resolved postoperatively. None suffered chest pain postoperatively. Postoperative hospital stay was 7.1 days. Only minor complications occurred postoperatively. The mean pectus severity index was 0.27 0.2 preoperatively and 0.41 0.1 postoperatively (p < 0.05). For children with restricted pulmonary function, it was 0.17 0.3 preoperatively and 0.38 0.2 postoperatively (p < 0.05). Mean percentage of predicted forced expiratory volume in 1 s changed significantly from 79.2% 17.8% preoperatively to 83.6% 12.2% by the 3rd postoperative month. For children with a pectus severity index 0.2 (18 cases, 6 with restricted pulmonary function), there was a difference in the mean PSI (0.31 0.05 vs. 0.43 0.02; p < 0.05) but not in the pre- and postoperative values of FEV1% (83 4.7 vs. 83.6 2.5, p ¼ 0.43). The mean preoperative FEV1% of children with PSI < 0.2 was less than that of the overall group (p < 0.05). FVC% values improved significantly postoperatively in both groups (Table 1). Pulmonary restriction correlated with a poor PSI (r ¼ 0.8; Figure 3). After 6 and 13 months, pulmonary function was similar, with a minor
Table 1. Results of pulmonary tests. Pectus severity index 0.2