Ten year experience of bioabsorbable mesh support in pectus excavatum repair

Luzzi, Luca; Voltolini, Luca; Zacharias, Joseph; Campione, Andrea; Ghiribelli, Claudia; Bisceglie, M. Di; Gotti, Giuseppe

doi:10.1016/j.bjps.2004.05.019

Cited by 17 publications

(14 citation statements)

References 25 publications

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“…Several studies in the pediatric Nuss and Ravitch groups reported postoperative improvement of symptoms, lung function, and cardiac function [24,53,54,56]. One study in the Robicsek group reported an improvement in symptoms and no change in lung function [61]. …”

Section: Resultsmentioning

confidence: 99%

“…Forty-four articles met the criteria for inclusion. These were stratified based on age range and treatment, providing seven subgroups: Nuss adult (n = 8) [32,35-41], Nuss pediatric (n = 22) [21,23-25,27,29,30,32,33,35],[39,42-52], Ravitch adult (n = 3) [53-55], Ravitch pediatric (n = 11) [24,25,27,29,30,55-60], Robicsek pediatric (n = 2) [57,61], Implant adult (n = 3) [18,20,62]. No other treatments had articles that satisfied the inclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

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Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum

Johnson

Fedor

Singhal

2014

J Cardiothorac Surg

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This compares outcome measures of current pectus excavatum (PEx) treatments, namely the Nuss and Ravitch procedures, in pediatric and adult patients. Original investigations that stratified PEx patients based on current treatment and age (pediatric = 0–21; adult 17–99) were considered for inclusion. Outcome measures were: operation duration, analgesia duration, blood loss, length of stay (LOS), outcome ratings, complications, and percentage requiring reoperations. Adult implant patients (18.8%) had higher reoperation rates than adult Nuss or Ravitch patients (5.3% and 3.3% respectively). Adult Nuss patients had longer LOS (7.3 days), more strut/bar displacement (6.1%), and more epidural analgesia (3 days) than adult Ravitch patients (2.9 days, 0%, 0 days). Excluding pectus bar and strut displacements, pediatric and adult Nuss patients tended to have higher complication rates (pediatric - 38%; adult - 21%) compared to pediatric and adult Ravitch patients (12.5%; 8%). Pediatric Ravitch patients clearly had more strut displacements than adult Ravitch patients (0% and 6.4% respectively). These results suggest significantly better results in common PEx surgical repair techniques (i.e. Nuss and Ravitch) than uncommon techniques (i.e. Implants and Robicsek). The results suggest slightly better outcomes in pediatric Nuss procedure patients as compared with all other groups. We recommend that symptomatic pediatric patients with uncomplicated PEx receive the Nuss procedure. We suggest that adult patients receive the Nuss or Ravitch procedure, even though the long-term complication rates of the adult Nuss procedure require more investigation.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum

Johnson

Fedor

Singhal

2014

J Cardiothorac Surg

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“…Modern techniques (minimally invasive repair of pectus excavatum) now involve using prosthetic material like a bioabsorbable mesh repair (17).…”

Section: Surgical Techniques For Correction Of Pectusmentioning

confidence: 99%

Anaesthetic considerations for pectus repair surgery

Patvardhan

Martínez

2016

J. Vis. Surg.

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Repair of pectus is one of the most common congenital abnormality for which patient presents for thoracic surgery. In recent years, innovative minimally invasive techniques involving video assisted thoracoscopy for pectus repair have become the norm. Similarly, anaesthetic techniques have evolved to include principles of enhanced recovery, multimodal analgesia and innovative ultrasound guided neuraxial and nerve blocks. Adequate anaesthetic set up and monitoring including the use of real time intraoperative monitoring with transesophageal echocardiography (TOE) has enabled the anaesthetist to enhance patient safety by providing instantaneous imaging of cardiac compression and complications during surgery. In this review article we aim to provide non-systematic review and institutional experience of our anaesthetic strategy to provide effective peri-operative care in this patient group.

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“…PE is the most frequent chest deformity in children, affecting 0.4%–1% of the population, with a male to female ratio of 4:1 [2]. Deformities of the chest wall are characterized by a funnel-shaped anterior region and by the reduction of the distance between the sternum and the spinal column.…”

Section: Introductionmentioning

confidence: 99%

A Sensorized Nuss Bar for Patient-Specific Treatment of Pectus Excavatum

Betti

Ciuti

Ricotti

et al. 2014

Sensors

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Pectus Excavatum is an anatomical deformation characterized by a depression of the anterior chest wall. Nuss technique (representing the current clinical golden standard) consists in the introduction of a corrective metal bar, in order to raise the sternum in its anatomic natural position. Nowadays, the bar plays purely a mechanical/corrective action and is kept implanted for about three years, supporting up to a maximum force of 250 N. Our study aims at optimizing the procedure of correction, in terms of monitoring the bar effect, minimizing the body response, and facilitating the bar removal. The sensorized Nuss bar prototype inserted in a platform for telemedicine described in this article is able to monitor in vitro pressure data variations, with more than 150 discrete measurements during the operating period. This behavior is promising for future clinical applications, in which the device could be exploited to monitor the forces at work, thus, providing a customized therapeutic protocol, which in turn may optimize the period of implant. The sensorized bar was also provided with a polymeric coating, able to influence human dermal fibroblast behavior in vitro. This highlights the possibility to minimize, in future in vivo applications, tissue fibrotic responses.

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Ten year experience of bioabsorbable mesh support in pectus excavatum repair

Cited by 17 publications

References 25 publications

Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum

Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum

Anaesthetic considerations for pectus repair surgery

A Sensorized Nuss Bar for Patient-Specific Treatment of Pectus Excavatum

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