The first experience of low-invasive correction of Pectus Carinatum at children by Abramson procedur

Abstract

Purpose: justification of relevance of use of a low-invasive method of correction across Abramson and improvement of treatment of pectus carinatum (PC) at children. Materials and methods. The result of treatment of 7 boys aged from 12 up to 17 years operated from 2012 to 2017 concerning PC in MRRCI was analyzed. 4 of them were operated in the open way on Ravich. A lot of sequels during and after operation led to refusal of open methods of correction of PC. In the period from 2015 to 2017 three children were operated by Abramson’s method. Dynamometer researches proved the efficiency of Abramson’s method. The multispiral computer tomography with 3D reconstruction was carried out and allowed to avoid possible intraoperative complications. During the operation were used epidural and general anesthesia. Allocation of ribs in places of bracing of stabilizers to a periosteum without injury of a pleura allowed to reach the best stability and reliability of fixatives, reduce a pain syndrome and avoid a possible injury of intrathoracic organs. Epidural anesthesia in combination with analgetics intramusculary provided optimum anesthesia during the postoperative period. This method leads to faster recovery after operation, 5 days vs 10 days. Results: the catamnesis collected from 1 month till 2 years is positive. At 1 patient the early postoperative period was complicated by the intense pheumothorax caused by a rupture of a bulla of an apex of the right lung. The thoracoscopic atypical resection of the violent changed site of a lung is executed. Inputs. Using of Abramson’s method allowed to reduce quantity possible intra-and postoperative complications, achieve amazing cosmetic result and reduce terms of hospitalization by 2,5 times.