Minimally invasive correction of asymmetric chest deformity in children

Abstract

Purpose. To analyze literature data and to find out optimal techniques for surgical correction of asymmetrical chest wall deformity in children.Material and methods. The researchers studied data on surgical treatment of children with asymmetrical chest wall deformity who had thoracoplasty performed with well-known techniques developed by Bairov, Timoshchenko, Paltia, Ravitch, Kondrashin which included the resection of crooked cartilage and internal metal fixation with consideration of deformity shape, location and severity. For comparison, the authors analyzed the data on the minimally invasive Nuss technique and its modifications.Results. The researchers found that thoracoplasty by the Bairov method is less effective which gives the largest number of postoperative complications (16.5%) in the form of hemothorax, pneumothorax and hydrothorax what significantly increased the length of hospital stay and the following rehabilitation process. On the contrary, minimally invasive interventions were the most effective, if to compare with all applied techniques for chest wall deformity correction, having a low percentage of complications; though their drawback is long-term postoperative analgesia.Conclusion. At present, there is no any consensus on the top-priority technique for surgical correction of chest wall deformity in children. It necessitates further research in this direction as well as improvement of the existing techniques and development of new ones.