Surgical management of pectus excavatum in China: results of a survey amongst members of the Chinese Association of Thoracic Surgeons

Shi, Ruiqing; Xie, Liang; Chen, Gang; Zeng, Qi; Mo, Xuming; Tang, Jiming; Zhou, Haiyu; Zhang, Dongkun; Zhou, Zihao; Tian, Dan; Deng, Cheng; Ben, Xiaosong; Qiao, Guibin

doi:10.21037/atm.2019.05.03

Cited by 9 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As the most common chest wall abnormality, pectus excavatum accounts for more than 90% of all congenital chest wall abnormalities (1). Most patients are healthy and the most common symptoms include exercise intolerance, dyspnea, chest pain, or palpitations (2).…”

Section: Discussion Among Physicians From Local Hospitalsmentioning

confidence: 99%

Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report

Wang¹,

Yu²,

Zhang³

et al. 2020

J Thorac Dis

View full text Add to dashboard Cite

Pectus excavatum (PE) is the most common chest wall deformity (1). Patients may complain of exercise intolerance, dyspnea, chest pain, or palpitations (2), severe symptoms like syncope are rare (3). Preoperative examinations could reveal distinct types of cardiac arrhythmia. However, there were no reports of combining with second-degree atrial-ventricular (AV) block (Mobitz II). Furthermore, pectus excavatum requiring temporary pacemaker implantation for the sake of a combination of the AV block before the operation was infrequent.We here presented a case of pectus excavatum combined with a second-degree AV block (Mobitz II), which also required a temporary pacemaker implantation before the Nuss procedure.We present the following case in accordance with the CARE reporting checklist (available at http://dx.doi.

show abstract

Section: Discussion Among Physicians From Local Hospitalsmentioning

confidence: 99%

Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report

Wang¹,

Yu²,

Zhang³

et al. 2020

J Thorac Dis

View full text Add to dashboard Cite

show abstract

“…Після корекції ЛДГК за Nuss корегуючи пластину видаляють за 2-4 роки після встановлення. Опитування серед членів китайської асоціації торакальних хірургів щодо хірургічного лікування ЛДГК [18] [15]. За 2-4 роки знаходження в тканинах корегуючої пластини та стабілізатора фіброзна тканина щільно зростається з цими конструкціями, тому на етапі їх видалення інколи зустрічаються значні труднощі та ускладнення у вигляді травми тканин та кровотеч [1,5,8,12].…”

Section: матеріали і методи досідженняunclassified

“…У цьому дослідженні у всіх пацієнтів була встановлена одна корегуюча пластина. У вище згаданому опитуванні китайських торакальних хірургів [18] щодо переваг встановлення двох корегуючих пластин, 91,2% опитаних хірургів вва-жають, що це забезпечує кращий ортопедичний ефект, 49,4% бачать перевагу в запобіганні рецидивам деформації, 34,1% -у запобіганні дислокації пластини, 21,8% вважають, що це дозволяє обійтись без додаткових розрізів та зменшує потребу у відкритій операції, та на думку 10% респондерів це зменшує інтенсивність болю. Тільки 2,9% хірургів були проти застосування двох пластин.…”

Section: матеріали і методи досідженняunclassified

“…͘ ϱ͘ ʪ̡̛̦̥̞̌̌ ̨̛̞̦̯̖̦̭̦̭̯̞̏ ̨̣̍̀ ̌̚ ʦʤˌ ̭̖̬̖̔ ̵̱̭̞ ̶̪̞̦̯̞̌̿̏ ;̭̥͘Ϳ ϯϲ /^^E ϮϯϬϰͲϬϬϰϭ ˈ̞̬̱̬̞̐́ ̸̨̨̛̯̔́̐ ̡̞̱̏ ζϰ;ϲϵͿͬϮϬϮϬ Оригінальні дослідження. Торакальна хірургія Читайте нас на сайті: http://med-expert.com.ua Опції післяопераційної аналгезії після корекції ЛДГК були наступні: 75,9% -пероральні анальгетики, 56,5% -внутрішньовенні анальгетики помпою, 54,1% -внутрішньом'язово або внутрішньовенно, 18,2% -епідуральна помпа, 14,7% -паравертебральна блокада та 13,5% -периферичні нервові блокади [18]. У цьому дослідженні при видаленні корегуючої пластини застосовувалася загальна анестезія з інтубацією та ШВЛ із двома варіантами аналгетичного компонента: опіоїди та паравертебральна блокада.…”

Section: матеріали і методи досідженняunclassified

See 1 more Smart Citation

The anesthesiologic management of bar removal after the Nuss procedure for repair of pectus excavatum

Myhal¹

2020

View full text Add to dashboard Cite

Introduction. The anesthesiologic management of bar removal after the Nuss procedure for repair of pectus excavatum is not clearly discussed in literature. The aim of the study: analysing the anesthetic technique of bar removal after the Nuss procedure for repair of pectus excavatum. Materials and methods. The prospective randomized study included 24 adolescents undergone the bar removal after the Nuss procedure for repair of pectus excavatum under general anesthesia with tracheal intubation and artificial lung ventilation. The patients were randomized into two groups according to the analgesia technique: in group PVA (n=14) bilateral paravertebral anaesthesia was used and in group G (n=10) fentanyl was used intraoperatively and ketoprophen – postoperatively. Intravenous induction: propofol 2–3 mg/kg, fentanyl 3–4 mcg/kg, atracurium 0.6 mg/kg. The maintenance of anesthesia: propofol 6–10 mg/kg/h, fentanyl 2 mcg/kg as needed. The following parameters were analyzed: blood pressure systolic (BPs), diastolic (BPd), mean (BPm), pulse rate (PR) and pain intensity using visual analogue scale (VAS). Results: The changes in hemodynamic parameters during surgery and anesthesia were statistically significant (p<0.05), but the hemodynamics was clinically stable. BP and PR were more decreased during anesthesia in group PVA than in group G. Anesthesia was adequate in both groups. There was no need in additional fentanyl bolus after the induction dose in PVA group. Patients in G group needed additional 200 mcg fentanyl during surgery. After surgery the pain intensity was significantly higher in group G than in group PVA: at recovery from anesthesia and extubation of trachea in group PVA – 0 (0–1), in group G – 3 (2–4) (U=1.5; р=0.000002); in the evening of the day of surgery in group PVA – 1 (0–1); in group G – 3 (2–3) (U=6.0; р=0.000031); in the next morning after surgery in group PVA – 0 (0-0); in group G – 1.5 (1–2) (U=12.0; р=0.00027) cm according to VAS. There was no patient with pain intensity higher than 3 cm, so all patients had adequate analgesia. Conclusion. Bilateral paravertebral anesthesia provides more adequate analgesia than systemic administration of analgesics perioperatively for bar removal after the Nuss procedure for pectus excavatum correction. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution. Informed consent of parents and children was obtained for the study. The author declares no conflict of interest. Key words: anesthesia, paravertebral block, pectus excavatum, Nuss procedure, bar removal.

show abstract

“…Pectus excavatum (PE) is the most common congenital chest wall deformity and is characterized by a visible depression in the sternum (1). PE deformities may constrict cardiopulmonary development in children and lead to heart displacement and obstructive pulmonary disease (2). Medical intervention is necessary in severe PE cases.…”

Section: Introductionmentioning

confidence: 99%

Surface topography index: a novel deformity severity assessment index for pectus excavatum

Wang¹,

Liu²,

Zhang³

et al. 2021

Transl Pediatr

View full text Add to dashboard Cite

Background: The surface topography index (STI) has great potential in both routine computed tomography (CT) scan and emerging optical imaging systems. However, the diagnostic accuracy and stability of the STI as a deformity severity assessment index has not been fully confirmed. Therefore, the aim of the present study was to determine the diagnostic performance of the STI as a novel deformity severity assessment index for pectus excavatum.Methods: The present study consisted of 722 chest CT images from a single center. The standard CT index (CTI) and STI were calculated for all patients. The between-group difference and the level of compliance between the CTI and STI was analyzed by t-test and Pearson correlation. The diagnostic value and optimum discriminatory values of the CTI and STI were calculated by a receiver-operating characteristic (ROC) curve and DeLong's test.Results: The distributions of the CTI and STI were similar and showed a slight overlap between the pectus excavatum (PE) and non-PE groups. Both the CTI and STI significantly differed between the 2 groups (P<0.001). The STI demonstrated a strong Pearson correlation with the CTI (r=0.91, 95% confidence interval: 0.88-0.91, P<0.001). The ROC curves showed that STI =1.58 (sensitivity: 0.93, specificity: 0.95) could be considered equivalent to CTI =2.72 (sensitivity: 0.93, specificity: 0.97) as the optimum discriminatory values. DeLong's test showed no significant difference in the ROC curve results between the CTI and STI (Z=0.90, P=0.37). Conclusions:The STI has comparative discrimination ability in PE diagnosis and deformity severity assessment when used with the standard CTI. The STI as a novel index is not only an ideal evaluation metric of PE deformity but also an objective trait for PE patients just as weight and height for everyone.

show abstract

Surgical management of pectus excavatum in China: results of a survey amongst members of the Chinese Association of Thoracic Surgeons

Cited by 9 publications

References 22 publications

Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report

Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report

The anesthesiologic management of bar removal after the Nuss procedure for repair of pectus excavatum

Surface topography index: a novel deformity severity assessment index for pectus excavatum

Contact Info

Product

Resources

About