Sternochondroplasty with metal blade retainers located retrosternal efficacy in patients with pectus excavatum

Abstract

Introduction: Pectus Excavatum (PE) is a deformity of the anterior chest wall, in which the sternum and rib cartilage presents an abnormal development. In these cases, the anterior thoracic wall presents a concave shape depression. Surgical treatment of this condition is a great need for patients, because symptoms are often severe and affect the quality of life of these patients. Objective: Present study aims to objectify early and late postoperative complications after it was performed sternochondroplasty with metal blade retainers located retrosternal. Material and methods: We conducted a retrospective observational study over a period of 20 years (1.10.1995-1.10.2015). In this regard I used casuistry of Surgical Clinic no. 1 of SCJU Mures. We introduced in the study 68 patients (41 male, 27 female) diagnosed with PE, on whom we practiced sternochondroplasty with metal blade retainers located retrosternal. Results: Mean age of the patients in the study was 17.4 years, with a range between 8 and 20 years. Most common symptoms on this patients were recorded: palpitations (n=23), exertional dyspnea (n=15), cough (n=15), chest pain (n=22) and dysphagia (n=2). Also 29 patients at clinical examination presented deformations of the spine (12 patients – kyphosis; 17 patients- scoliosis). The degree of deformation was evaluated by measuring the angle formed by the body of the sternum and the manubrium towards the spine. Thereby, we obtained the following results: 42 patients had an angle of 10 to 15 degrees; 20 patients had an angle of 15 to 20 degrees and 11 patients with an angle greater than 20 degrees. Of the total number of operated patients, 11 had immediate postoperative complications, as follows: 3 hematoma patients, 4 patients with bilateral pneumothorax, 3 with unilateral pneumotorax and one patient experienced hemorrhage at cartilage section. Late complications were represented by 2 cases of thoracic deformity recurrence and 4 cases of patients with keloid scars. In the study group we observed that early complication rate was 16%, while the late complications rate was 9%. Conclusions: Surgery is the only treatment able to lead to improvements of symptoms in patients with PE. Sternochondroplasty with metal blade disposed retrosternal represents a viable surgical method of treatment of these parietal chest defects.