Radiological assessment of surgical treatment results in children and adolescents with pectus excavatum: medium-term results of 75 cases

摘要

Objective?—?Minimally?invasive?repair?of?pectus?excavatum?(PE)?has?been?established?as?the?preferred?technique?for?the?repair?of?PE.?Modified?techniques?of?repair?based?on?D.?Nuss?method?for?PE?are?promoted?to?improve?the?safety?of?the?procedures.?Purpose?of?this?work?was?to?analyzing?the?operative?results?with?accounting?of?the?toracometric?parameters?of?pectus?excavatumin?children?and?adolescents.?Methods?—?Toracometric?parameters?were?the?followings,?as:?sternum?rotation,?cardiac?and?pulmonary?vein?rotation?angles,?Haller?and?asymmetry?indices?in?children?and?adolescents?with?PE.?48?(64%)?patients?are?operated?by?D.?Nuss?procedure?and?27?(36%)?with?modifications,?due?to?severity?of?diagnostic?parameters,?which?were?exhibited?the?significance?difference?between?pre‐?and?postoperative?indices,?mainly,?in?patients?who?has?a?severe?degree?changes?preoperatively.?Results?—?The?sternum?rotation?degree?(in?75?patients)?was?decreased?till?0.4±0.02°?(P=0.01),?whereas?was?20.7±0.46°?preoperatively?(P=0.001).?Preoperatively,?the?mean?of?cardiac?rotation?angle?significantly?reduced,?preoperative?was?56.0±2.9°?(P=0.001)?(in?75?patients)?and?after?operative?intervention?made?up?47.0±2.7°?(P=0.001).?Haller?index?also?is?decreased?till?2.3±0.2,?whereas?was?3.9±0.2?preoperatively?(P=0.002).?The?angle?of?the?pulmonary?vein?rotation?was?preoperatively?51.0±3.4°?(P=0.001)?and?after?operation?was?increased?till?53.0±1.8°?(P=0.01).?Conclusions?—?It?has?necessity?apply?the?computer?tomography?investigation?in?patients?with?PE?deformity.?Also,?it?cannot?miss?the?stage?of?the?sterno‐costal?complex?strength,?its?pliability?and?the?gravity?of?the?sternum?rotation,?which?may?lead?to?raise?the?share?of?good?and?excellent?results.