Improved cardiopulmonary exercise function after modified Nuss operation for pectus excavatum

Tang, Mariann; Nielsen, Henning Overgaard; Lesbo, Maj; Frøkiær, Jørgen; Maagaard, Marie; Pilegaard, Hans K.; Hjortdal, Vibeke E.

doi:10.1093/ejcts/ezr170

Cited by 62 publications

(48 citation statements)

References 16 publications

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“…The [9][10][11]13], that is, the excavated deformity is repaired without any type (wedge or transversal) of the sternotomy and cartilages resection [12] of abnormally developed parts of the ribs and in another 27 (36%) patients the PE deformation was corrected by modification of D. Nuss procedure and the small statistical validity (P<0.05) was determined between two groups. The patients were distributed by correction method, which is shown in Table 1.…”

Section: Methodsmentioning

confidence: 99%

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

Khakimov¹,

Khodjanov²,

Khodjibekova³

et al. 2014

RusOMJ

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Abstract: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 excavatum in 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.

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Section: Methodsmentioning

confidence: 99%

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

Khakimov¹,

Khodjanov²,

Khodjibekova³

et al. 2014

RusOMJ

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“…Other than vomiting caused by inadequate dissection, surgical wound infection is a possible postoperative complication after open pyloromyotomy for hypertrophic pyloric muscle (5)(6)(7)(8)(9)11,17,18,27). The incision methods used in open pyloromyotomy that influence the incidence of surgical wound infection include right-upper quadrant horizontal incision and supraumbilical incision as well as whether pyloromyotomy is performed intra or extra-corporeally (12,15,28,29). No authors report the presence of specific postoperative complications after laparoscopic surgery.…”

Section: ■ Explanationmentioning

confidence: 99%

“…Among the articles selected for these guidelines, there are no meta-analyses, RCTs, or non-randomized prospective controlled trials that provide high-level evidence. There is only an analytic epidemiologic study including Nissen fundoplication (27) as well as a descriptive study of Toupet fundoplication (28). The analytic epidemiologic study (27) investigated laparoscopic fundoplication performed for children without neurologic disorders and reports that Nissen and Toupet fundoplication show no difference with respect to the incidence of intraoperative or postoperative complications, postoperative dysphagia, or reoperation.…”

Section: ■ Explanationmentioning

confidence: 99%

Pediatric Surgery

Iwanaka¹,

Yamataka²,

Uemura³

et al. 2015

Asian J Endoscop Surgery

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“…However, recent studies have refuted this statement and shown physiological improvement after surgical correction in the form of improved cardiac function (8)(9)(10), chest wall motion (11), and lung function (12). Nonetheless, cosmetic complaints are still the main indication for patients to undergo correction (13).…”

Section: Introductionmentioning

confidence: 99%

A prospective study on quality of life in youths after pectus excavatum correction

Lomholt

Jacobsen²,

Thastum

et al. 2016

Ann. Cardiothorac. Surg.

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Background: The impact of correction of pectus excavatum (PE) on adolescents' health-related quality of life (HRQL) has only been investigated in prospective designs using disease-specific measures and without controls. The aim of this prospective study was to evaluate the HRQL before and after surgical correction of PE using a generic HRQL measure, and to compare the reported level of HRQL before surgery with an age-comparable control group.Methods: Patients (n=107) and one of their parents (n=106) completed the generic HRQL measure: the Child Health Questionnaire before, 3 months, and 6 months after correction for PE. A control group (n=183) consisting of school children comparable in age completed the same measure on one occasion. Results:The patients' level of HRQL before surgery was comparable to the level of the controls except for physical functioning; here boys reported impaired function compared to controls (P<0.0001, d=0.72).Both patients and parents reported improved emotional wellbeing and self-esteem, as well as an increase in physical and social activities from pre-to post-surgery. These improvements were statistically significant (P≤0.001-0.03) and yielded moderate to high effect sizes (ƞ 2 =0.04-0.22). Conclusions:The improvement of physical and psychosocial HRQL reported by both patients and their parents as proxy indicates the psychological implications of the deformity. Patients reported impaired physical function compared to controls. Further, pre-surgery differences in HRQL between the patients and the controls were lacking. However, the improvement in the patients' HRQL following surgery may justify the correction of pectus excavatum. The effect of the deformity on patients wellbeing compared with controls' needs to be addressed in further studies.

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Improved cardiopulmonary exercise function after modified Nuss operation for pectus excavatum

Abstract: Patients with pectus excavatum have lower cardiac index at submaximal exercise when compared with healthy age-matched controls. Their cardiac index and FEV(1) are increased one year after the modified Nuss operation.

Cited by 62 publications

References 16 publications

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

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

Pediatric Surgery

A prospective study on quality of life in youths after pectus excavatum correction

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