Die „neue” Erlanger Trichterbrustkorrektur - Minimalisierung eines bewährten Verfahrens

Pg, Weber; Hp, Hümmer

doi:10.1055/s-2006-956178

Cited by 13 publications

(2 citation statements)

References 7 publications

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“…The surgical procedure is known as the Erlangen technique of funnel chest correction. 17 For moving the sternum in the desired position, first the sternum is freed through an interior incision and then it is mobilized by freeing of the xiphisternum. After correction of the chest, the chest wall is stabilized with a lightweight transsternal metal implant.…”

Section: Methodsmentioning

confidence: 99%

Association of genetic and psychological factors with persistent pain after cosmetic thoracic surgery

Dimova¹,

Lötsch²,

Hühne³

et al. 2015

JPR

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The genetic control of pain has been repeatedly demonstrated in human association studies. In the present study, we assessed the relative contribution of 16 single nucleotide polymorphisms in pain-related genes, such as cathechol-O-methyl transferase gene (COMT), fatty acid amino hydrolase gene (FAAH), transient receptor potential cation channel, subfamily V, member 1 gene (TRPV1), and δ-opioid receptor gene (OPRD1), for postsurgical pain chronification. Ninety preoperatively pain-free male patients were assigned to good or poor outcome groups according to their intensity or disability score assessed at 1 week, 3 months, 6 months, and 1 year after funnel chest correction. The genetic effects were compared with those of two psychological predictors, the attentional bias toward positive words (dot-probe task) and the self-reported pain vigilance (Pain Vigilance and Awareness Questionnaire [PVAQ]), which were already shown to be the best predictors for pain intensity and disability at 6 months after surgery in the same sample, respectively. Cox regression analyses revealed no significant effects of any of the genetic predictors up to the end point of survival time at 1 year after surgery. Adding the genetics to the prediction by the attentional bias to positive words for pain intensity and the PVAQ for pain disability, again no significant additional explanation could be gained by the genetic predictors. In contrast, the preoperative PVAQ score was also, in the present enlarged sample, a meaningful predictor for lasting pain disability after surgery. Effect size measures suggested some genetic variables, for example, the polymorphism rs1800587G>A in the interleukin 1 alpha gene (IL1A) and the COMT haplotype rs4646312T>C/rs165722T>C/rs6269A>G/rs4633T>C/rs4818C>G/rs4680A>G, as possible relevant modulators of long-term postsurgical pain outcome. A comparison between pathophysiologically different predictor groups appears to be helpful in identifying clinically relevant predictors of chronic pain.

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Section: Methodsmentioning

confidence: 99%

Association of genetic and psychological factors with persistent pain after cosmetic thoracic surgery

Dimova¹,

Lötsch²,

Hühne³

et al. 2015

JPR

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“…The marginal dissemination of such technical modifications might be a reason, why conventional repairs were still prevalent in Germany, particularly in adults aged 25 and older. On the other hand, techniques for open repair of pectus excavatum have enjoyed much popularity in Germany [24] and been advocated by influential surgeons of their periods such as Rehbein's method [25], the Willital-Hegemann procedure [26], and the Erlangen method [27]. We may thus not exclude that these factors played a role in the dissemination of the minimally invasive funnel chest repair.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of funnel chest repairs in Germany: monitoring the success of Nuss’ procedure

Heydweiller

Sochaczewski

2022

Cardiothorac Surg

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Background In recent years, the Nuss procedure was gaining ground in pectus excavatum repair, but the scientific focus had been on complications compared to conventional repairs. Despite a substantial prevalence of pectus excavatum in population-based studies, the adoption of minimally invasive funnel chest repair and subsequent replacement of conventional procedures has not been assessed on a population-based level. Methods We analysed German administrative case-based data on funnel chest repairs separate by age group and operative procedure: conventional or minimally invasive. Changes over time between 2010 and 2018 were analysed by linear regression. Results There were x̅ = 256 operations per year, which did not change throughout the study time, but following the introduction of minimally invasive repairs, their usage increased particularly in males aged 15 to 19 years by 8.7 procedures per year (P = 0.0142) and was accompanied by a concomitant decrease in conventional repairs in all relevant age groups. We observed a shift of operations towards the age group of 15 to 19 years, whose numbers increased by 5.3 yearly procedures (P = 0.0222), whereas they decreased in all other relevant age groups. These shifts could not be observed in females in a similar fashion, but in both males and females, the numbers of minimally invasive per conventional repair increased. Conclusions In Germany, the introduction of the Nuss procedure did result in a concentration of funnel chest repairs in adolescence and a replacement of conventional repairs. Data from other healthcare systems are missing but are direly needed to assess the current situation in other healthcare systems. Level of evidence III.

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Special aspects in females

Schwabegger¹

2011

Congenital Thoracic Wall Deformities

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Die „neue” Erlanger Trichterbrustkorrektur - Minimalisierung eines bewährten Verfahrens

Cited by 13 publications

References 7 publications

Association of genetic and psychological factors with persistent pain after cosmetic thoracic surgery

Association of genetic and psychological factors with persistent pain after cosmetic thoracic surgery

The epidemiology of funnel chest repairs in Germany: monitoring the success of Nuss’ procedure

Special aspects in females

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