Minimally invasive endoscopic repair of pectus excavatum

Jacobs, Jeffrey P.; Quintessenza, James A.; Morell, Victor O.; Botero, Luis M.; Gelder, Hugh M. van; Tchervenkov, Christo I.

doi:10.1016/s1010-7940(02)00069-6

Cited by 42 publications

(22 citation statements)

References 7 publications

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“…The ages of the patients who wereoperated on by the MIrPE procedurew as 5y earsh igher (14)(15)(16) years) at the end of our series than at the beginning. Ahigher age decreases the incidence of relapses after the bar removal.…”

Section: Discussionmentioning

confidence: 76%

Minimally Invasive Repair for Treating Pectus Excavatum — Early Results

2008

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Results: operative mortality was zero and there were no clinically significant bleeding complications. epidural analgesia was necessary for adequate pain control. small symp tomless residual pneumothoraxes and pleural effusions were common after the operation but neither required intervention. one patient had ah emothorax 7m onths postopera tively,which was cured with asingle puncture. bar displacement took place in 2patients but required correction in only one of these patients. there were 2wound infections, one superficial and one which led to removal of the bar was 6m onths after the operation. this may have been unnecessary.t wo patients had pneumonia, one probably unrelated to the operation. one patient required psychiatric ward treatment, and 3p atients had mild psychological symptoms not requiring specific therapy.t he preliminary cosmetic results were good or excellent in 90% of the cases, but alonger followup is needed for information on the final outcome.Conclusions: Mirpe is as afe operation and gives ac osmetically good result. thora coscopy is needed during the operation. the early postoperative period in hospital is painful and there the patients need intensive care. We found the high epidural analgesia beneficial and safe during early period of pain treatment. the bar is removed not earlier than 3years after the operation as aday care surgical procedure.

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Section: Discussionmentioning

confidence: 76%

Minimally Invasive Repair for Treating Pectus Excavatum — Early Results

2008

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“…Thirty-two [4,38] publications with 2997 patients (median: 53; range: 10-947) reported results following MIRPE with the metallic bars in situ (Table 1). Twenty-three publications [4,6,11,[13][14][15][16][17]21,[23][24][25][26][27][30][31][32][33][34][35][36][37][38] with 1393 (median: 36; range: 6-521) patients reported results after MIRPE completion with the bar(s) having been removed (Table 2). One study reported the results of MIRPE in 50 patients in whom a previous, conventional repair of PE had failed (redo surgery) [27].…”

Section: Resultsmentioning

confidence: 99%

“…Eighteen studies [6,7,11,13,15,[20][21][22][23]25,27,29,31,32,34,36,39,41] (Table 1) report from a mixed population from all three age groups. Five publications [4,[8][9][10]18] report from a mixed paediatric and adolescent population.…”

Section: Age At Time Of Mirpementioning

confidence: 99%

Minimally invasive repair of pectus excavatum deformity

Krasopoulos

Goldstraw

2011

European Journal of Cardio-Thoracic Surgery

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This review is trying to address the effectiveness and sustainability of results following minimally invasive repair of pectus excavatum (MIRPE). The aim is to present these results for the benefit of clinicians and the patients. Literature search has revealed 179 hits, which were independently assessed and led to 80 publications being formally reviewed. Studies reporting results from less than 10 patients were excluded. Thirty-five studies were found to be reporting results from patients' and/or surgeons' perspective and they were included in this review. Data from the United Kingdom registry for MIRPE were also included. Results from over 2997 patients (age: <1-85 years) who had MIRPE and 1393 patients who had their metallic bar removed were assessed. The most common indication for surgery was cosmesis. There was a net gain with regard to self-esteem for 96-100% of the individuals. A percentage of procedures (0-20%) was assessed by surgeons as having an 'unsatisfactory outcome' and a number of patients (0-25%) reported an 'unsatisfactory end result.' However, these percentages are not necessarily referring to the same patients and an unsatisfactory result does not seem to affect the positive effect on self-esteem. The reported changes in social life, lung capacity, cardiovascular capacity, exercise capacity and general health are based on weak data and significant improvements, if any, are probably seen in a limited number of patients. The metallic bars were removed after 1.5-4.5 years and there is an overall 0-4.5% reported recurrence post-bar removal. In conclusion, MIRPE may improve cosmesis and self-esteem of patients with pectus excavatum deformity. Direct or indirect improvement in other physiological parameters may also help the 'well-being' of these patients and their social integration. There is a clear need for standardisation in the way results are reported in the literature and a socioeconomic analysis with regard to gains, benefits and costs related to MIRPE.

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“…Through the years, minor modifications have been applied, but the main idea of the method remained the same and the Ravitch repair was the treatment of choice until the mid-1990s. Since its introduction by Nuss et al [4] in 1997, the minimally invasive repair of pectus excavatum (MIRPE) has been gaining acceptance worldwide among surgeons and patients [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%