Pectus carinatum is a chest wall deformity, sometimes associated with physical signs and symptoms, but always associated to significant psychological distress. Surgical correction used to be the only solution, and was therefore only indicated for the most severe cases. Non-surgical approaches have been developed and improved during the last 15-20 years. A paradigm shift occured when the medical community realized that, despite the wall deformity, the chest wall was not completely rigid, but flexible and capable of remodeling. Several bracing devices and protocols are available as of today. This article will focus specifically in the FMF ® Dynamic Compressor System (DCS), which was developed in Argentina in 2001and is currently used worldwide.
Poland syndrome is a rare congenital anomaly characterized by unilateral chest wall hypoplasia and ipsilateral hand abnormalities. The indications for chest and breast reconstruction are determined on the basis of functional and aesthetic concerns. The traditional open approach uses a latissimus dorsi muscle flap to attain chest symmetry. Endoscopically assisted latissimus dorsi muscle harvesting has been reported previously, combined with an additional incision for muscle fixation. We present a case series using minimally invasive surgery in Poland syndrome. In our last case, latissimus dorsi muscle harvesting and transposition was performed completely videoendoscopically. We believe we are the first to report this technique in the literature.
Of the 165 patients with UC in our hospital, 32 underwent surgery. The laparoscopic approach seems feasible and safe. A single staged approach (Group 1 + Group 2) remains the most reasonable choice for most patients. One-step approach was done only in selected cases (Group 3). The advantages of laparoscopy, such as improved cosmetic aspects, shorter postoperative ileus and hospital stay, were observed in the laparoscopic colectomy, proctectomy and ileoanal pouch in our study.
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