IntroductionThe minimally invasive pectus carinatum surgery described by Abramson has been performed in many centers. We modified the “sub-muscular tunnel creation” part of the original Abramson technique.AimTo compare the operative time between the original Abramson technique and a lightly modified approach.Material and methodsA retrospective review of 84 patients who underwent minimally invasive repair of pectus carinatum deformity between July 2008 and November 2017 was performed. We applied two different techniques, the original Abramson technique and the modified technique. Sixty-eight patients – 49 (72%) males and 19 (28%) females – underwent minimally invasive repair of a pectus carinatum deformity as described by Abramson (Abramson group). Sixteen patients – 13 (81%) males and 3 (19%) females – were operated on by our modified Abramson technique at our institution (Modified group).ResultsEighty-four patients were included in this study: 68 patients from the Abramson group and 16 patients from the Modified group. There was no significant difference between the groups with respect to preoperative demographic features, including median age and sex. Median operative time was significantly shorter in the Modified group than the Abramson group (43 min, range: 32–54 min) in the Modified group vs. 30 min (range: 20–35 min) in the Abramson group (p < 0.001).ConclusionsThis article describes a modification of a surgical technique that is safely and easily used in minimally invasive correction of pectus carinatum deformities, with minimal complications, high satisfaction rates and shorter operative time.
Background: Although the NLR and PLR are cheap and widely available biomarkers, literature regarding their usage in trauma patients is scarce. It seemed to us interesting to evaluate the prognostic value of the NLR and PLR for trauma patients. In this manner, we selected a small group of trauma patients with sternal fractures and aimed to investigate their correlation with the serum NLR and PLR. To the best of our knowledge, this is the first study investigating the clinical value of these cheap and widely available biomarkers in trauma patients. Materials and Methods: We designed a retrospective study examining the utility of NLR and PLR in estimating trauma severity in sternum fracture patients who admitted to our hospital between January 2013 and April 2018. Patients were divided into two groups: isolated sternum fracture group (36 patients with sternal fracture and without any complications in thorax or other system and/or only 1 or 2 rib fractures) and complicated sternum fracture group (19 patients with sternal fracture and with associated complications in thorax or other systems). Injuries were not graded but referred as severe according to the associated complications in thorax or other systems. The key clinical parameters, including NLR and PLR were compared among the groups. Results: Based on the ROC curve, the best NLR cutoff value to predict complicated sternum fracture group patients was 2.1, with 88.9% sensitivity and 28% specificity, whereas the best PLR cutoff value was 123.8, with 72% sensitivity and 68% specificity. Conclusions: The results may indicate a clinically useful marker that can be easily and reliably measured from a blood sample to predict outcome of trauma patients with sternal fractures.
INTRODUCTIONSurgical treatment of benign thyroid diseases need to be followed up closely, since recurrent thyroid nodules can be seen after subtotal thyroidectomy. Intrathoracic goiter (ITG) occurs in 10–30% of patients following subtotal thyroidectomy. In general these goiters are benign, having a malignant rate of only 2–22%. ITG grows slowly but steadily and in its process of development, it narrows the thoracic inlet by compressing the surrounding structures. Most of these can not located in the anterior mediastinum, others located in posterior retrovascular area. Bilateral posterior retrovascular goiters are very rare.PRESENTATION OF CASEWe report a case involving a 61-year-old woman with history of gradual-onset dyspnea who was referred to us for evaluation of a large mediastinal mass. She had undergone bilateral thyroid lobectomy for a cervical goiter 10 years ago. The mass was removed successfully via median sternotomy without complication. The patient recovered well and was discharged in 1 week.DISCUSSIONMost anterior mediastinal goiters can be resected through a transcervical approach, but if those extending beyond the aortic arch into the posterior mediastinum are better dealt with by sternotomy or lateral thoracotomy.CONCLUSIONBilateral recurrent posterior mediastinal and retrovascular large goiters are better resected via sternotomy rather than lateral thoracotomy. The reason for that are the possibility of injury to large vascular structures and the difficulty of their management through lateral thoracotomy when cardiopulmonary bypass needed.
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