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Pectus excavatum

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https://www.readbyqxmd.com/read/29198628/revision-of-failed-prior-nuss-in-adult-patients-with-pectus-excavatum
#1
Awais Ashfaq, Staci Beamer, MennatAllah M Ewais, Jesse Lackey, Dawn Jaroszewski
BACKGROUND: Minimally invasive repair of pectus excavatum (MIRPE) has been extended to repair of defects in adults, with reported higher complication rates and outcome failures. The optimal revision for a prior failed MIRPE in an adult has not been identified. We review our experience for this adult population. METHODS: A retrospective review was performed of 129 patients (age ≥18 years) who underwent revision after a failed pectus excavatum (PE) repair from December 2010 through December 2016...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29162223/effects-of-pectus-excavatum-repair-on-right-and-left-ventricular-strain
#2
Chieh-Ju Chao, Dawn Jaroszewski, Michael Gotway, MennatAllah Ewais, Susan Wilansky, Steven Lester, Samuel Unzek, Christopher P Appleton, Hari P Chaliki, Brantley D Gaitan, Farouk Mookadam, Tasneem Z Naqvi
BACKGROUND: The cardiopulmonary benefits of pectus excavatum repair have been debated. Echocardiographic speckle-tracking strain and strain rate have been used to evaluate and detect subclinical myocardial dysfunction in patients receiving cardiotoxic chemotherapy, and patients with valvular heart disease. This technology was applied to evaluate the effects of pectus excavatum surgery on left ventricular (LV) and right ventricular (RV) function. METHODS: Speckle tracing strain evaluation was performed on intraoperative transesophageal echocardiographic images acquired immediately before and after Nuss repair in adult patients (aged 18 years or more) from 2011 to 2014...
November 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29156016/pectus-excavatum-repair-after-sternotomy-the-chest-wall-international-group-experience-with-substernal-nuss-bars
#3
Dawn E Jaroszewski, Paul J Gustin, Frank-Martin Haecker, Hans Pilegaard, Hyung Joo Park, Shao-Tao Tang, Shuai Li, Li Yang, Sadashige Uemura, Jose Ribas Milanez De Campos, Robert Obermeyer, Frazier W Frantz, Michele Torre, Lisa McMahon, Andre Hebra, Chih-Chun Chu, J Duncan Phillips, David M Notrica, Antonio Messineo, Robert Kelly, Mustafa Yüksel
OBJECTIVES: Patients with pectus excavatum (PE) after prior sternotomy for cardiac surgery present unique challenges for repair of PE. Open repairs have been recommended because of concerns about sternal adhesions and cardiac injury. We report a multi-institutional experience with repair utilizing substernal Nuss bars in this patient population. METHODS: Surgeons from the Chest Wall International Group were queried for experience and retrospective data on PE repair using sub-sternal Nuss bars in patients with a history of median sternotomy for cardiac surgery (November 2000 to August 2015)...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29138688/effect-on-chest-deformation-of-simultaneous-correction-of-pectus-excavatum-with-scoliosis
#4
Jin-Duo Ye, Guang-Pu Lu, Jing-Jing Feng, Wei-Hong Zhong
Objective: This paper is to understand the effect of simultaneous correction of pectus excavatum with scoliosis and to provide some useful information for clinical orthopedic surgery design. Methods: The method of a three-dimensional reconstruction has been used to the reconstruction of the chest model of pectus excavatum with scoliosis, and the numerical stimulation has been conducted to the process of minimally invasive correction. Three kinds of correction methods have been considered in the numerical simulation, stretch spine, stretch spine and minimally invasive correction at the same time, and release stretch spine after stretch spine and minimally invasive correction of pectus excavatum at the same time...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29078605/uniportal-nuss-procedure-for-pectus-excavatum-where-to-place-the-camera-but-we-ve-always-done-it-this-way
#5
Ivan Schewitz
This study was stimulated by the increasing use of uniportal thoracoscopic surgery. If a lobectomy can be performed through one small incision why not the much simpler Nuss procedure? The Nuss procedure was performed with the use of the surgical incision for the camera. Initially the patient was positioned so that the standard site for the camera could be utilized. Once it become obvious that the uniportal approach worked the patient was positioned in the middle of the table. In all cases the uniportal approach in my hands was easy and made the operation less cumbersome...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29065615/effects-of-pectus-excavatum-on-the-spine-of-pectus-excavatum-patients-with-scoliosis
#6
WeiHong Zhong, JinDuo Ye, JingJing Feng, LiYang Geng, GuangPu Lu, JiFu Liu, ChunQiu Zhang
BACKGROUND: There is high risk in the correction surgery of pectus excavatum with scoliosis because of the lack of the correction mechanism of pectus excavatum with scoliosis. This study performed a comprehensive analysis about the impact that pectus excavatum had on scoliosis and elaborated its biomechanical mechanism in pectus excavatum patients with scoliosis. METHODS: 37 pectus excavatum patients were selected. According to age, Haller index of pectus excavatum, offset coefficient, vertical position, sternal torsion angle, and asymmetric index, 37 patients were, respectively, divided into 2 compared groups...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29063665/a-retrospective-comparison-of-thoracic-epidural-infusion-and-multimodal-analgesia-protocol-for-pain-management-following-the-minimally-invasive-repair-of-pectus-excavatum
#7
Janice Y Man, Harshad G Gurnaney, Scott R Dubow, Theresa J DiMaggio, Gina R Kroeplin, N Scott Adzick, Wallis T Muhly
BACKGROUND: Pain management following minimally invasive repair of pectus excavatum is variable. We recently adopted a comprehensive multimodal analgesic protocol that standardizes perioperative analgesic management. We hypothesized that patients managed with this protocol would use more opioids postoperatively, have similar pain control, and shorter length of stay compared to patients managed with thoracic epidural infusion. AIMS: We retrospectively compared opioid consumption, pain scores, and length of stay between a cohort of patients managed with our multimodal analgesic protocol and a cohort managed with a thoracic epidural infusion...
October 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29052000/results-of-pectus-excavatum-correction-using-a-minimally-invasive-approach-with-subxyphoid-incision-and-three-point-fixation
#8
Sheldon J Bond, Emily Rapstine, Jordan M Bond
OBJECTIVES: This study reviews the results of our previously described modification of the minimally invasive (Nuss) procedure for correction of pectus excavatum. It utilizes a subxyphoid incision with central fixation to maximize safe bar passage and minimize bar displacement. METHODS: Consecutive patients corrected with the modified Nuss procedure between 2010 and 2015 form the basis of this study. RESULTS: During the study period, 73 patients had correction of their pectus excavatum by the modified Nuss procedure, utilizing subxyphoid incision and central fixation...
October 19, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29050466/pectus-excavatum-a-rare-cause-of-gastric-subepithelial-lesion
#9
Sung Yong Han, Gwang Ha Kim
No abstract text is available yet for this article.
October 19, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29049840/evaluating-interest-in-narrative-therapy-for-decision-making-about-pectus-excavatum-treatment
#10
Davide Ticchi, Robert S Eisinger, Hans K Pilegaard, Michele Torre, Sergio B Sesia, Maurizio Infante, Emanuele Voulaz, Mauricio Arce Quesada, Merike Sisask
OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely clear-cut. Patients interested in treatment are referred for evaluation by numerous different specialists, but psychosocial counselling is currently not included in this process. Our objective was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles. METHODS: Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions, with 3 questions specifically evaluating interest in narrative therapy...
September 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29033723/postoperative-pain-management-in-patients-undergoing-thoracoscopic-repair-of-pectus-excavatum-a-retrospective-analysis-of-opioid-consumption-and-adverse-effects-in-adolescents
#11
Ralph Beltran, Giorgio Veneziano, Tarun Bhalla, Brian Kenney, Dmitry Tumin, Bruno Bissonnette, Joseph D Tobias
INTRODUCTION: Although the Nuss procedure provides excellent cosmetic results for the correction of pectus excavatum, the provision of analgesia following such procedures can be challenging. METHODS: The current study retrospectively reviews our experience over a 2.5 year period with thoracic epidural analgesia (TE), paravertebral blockade (PVB), and intravenous opioids delivered via patient-controlled analgesia (PCA) to provide postoperative analgesia. RESULTS: The study cohort included 30 patients (mean age = 15...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033015/analyzing-effectiveness-of-routine-pleural-drainage-after-nuss-procedure-a-randomized-study
#12
Krystian Pawlak, Łukasz Gąsiorowski, Piotr Gabryel, Szymon Smoliński, Wojciech Dyszkiewicz
BACKGROUND: The routine use of postoperative pleural cavity drainage after the Nuss procedure is not widely accepted, and its limited use depends on experience. This study analyzed the influence of pleural drainage in the surgical treatment of patients with pectus excavatum on the prevention of pneumothorax and the efficacy of using drainage after a corrective operation. METHODS: From November 2013 to May 2015, 103 consecutive patients with pectus excavatum, aged 11 to 39 years, underwent surgical treatment by the Nuss procedure...
October 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29027531/-costal-cartilage-structural-and-functional-changes-in-children-with-a-funnel-or-keeled-chest
#13
A V Kurkov, A B Shekhter, V S Paukov
Congenital chest wall deformities (CCWDs) in children are severe diseases leading to cosmetic defects and diseases of the respiratory and cardiovascular systems. The most common of these deformities are funnel-shaped (pectus excavatum, FD) and keeled (pectus carinatum, KD) ones. The pathogenesis of CCWDs and the role of costal cartilage structural and functional changes in their pathogenesis have now been not well studied, which makes it difficult to elaborate pathogenetic approaches to correcting these diseases...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/29023602/trace-metal-release-after-minimally-invasive-repair-of-pectus-excavatum
#14
Caroline Fortmann, Thomas Göen, Marcus Krüger, Benno M Ure, Claus Petersen, Joachim F Kübler
BACKGROUND: Several studies have shown a high incidence of metal allergy after minimally-invasive repair of pectus excavatum (MIRPE). We postulated that MIRPE is associated with a significant release of trace metal ions, possibly causing the allergic symptoms. METHODS: We evaluated the concentration with chromium, cobalt and nickel in blood, urine and tissue in patients prior to MIRPE and in patients who underwent an explantation of the stainless-steel bar(s) after three years...
2017: PloS One
https://www.readbyqxmd.com/read/28962496/complications-after-pectus-excavatum-repair-using-pectus-bars-in-adolescents-and-adults-risk-comparisons-between-age-and-technique-groups
#15
Soohwan Choi, Hyung Joo Park
OBJECTIVES: To compare the complications associated with age and technique groups in patients undergoing pectus excavatum (PE) repair. METHODS: The data of 994 patients who underwent PE repair from March 2011 to December 2015 were retrospectively reviewed. Mean age was 9.59 years (range 31 months-55 years), and 756 patients were men (76.1%). The age groups were defined as follows: Group 1, <5 years; Group 2, 5-9 years; Group 3, 10-14 years; Group 4, 15-17 years; Group 5, 18-19 years; Group 6, 20-24 years; and Group 7, >24 years...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28940665/prediction-of-persistent-post-operative-pain-pain-specific-psychological-variables-compared-with-acute-post-operative-pain-and-general-psychological-variables
#16
C Horn-Hofmann, J Scheel, V Dimova, A Parthum, R Carbon, N Griessinger, R Sittl, S Lautenbacher
BACKGROUND: Psychological variables and acute post-operative pain are of proven relevance for the prediction of persistent post-operative pain. We aimed at investigating whether pain-specific psychological variables like pain catastrophizing add to the predictive power of acute pain and more general psychological variables like depression. METHODS: In all, 104 young male patients undergoing thoracic surgery for pectus excavatum correction were studied on the pre-operative day (T0) and 1 week (T1) and 3 months (T2) after surgery...
September 20, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28935331/modified-ravitch-procedure-for-left-poland-syndrome-combined-with-pectus-excavatum
#17
Gildardo Cortés-Julián, Hussein B Bushra-Nuritu, Renata Buenfil-Fuentes, José A Merino Rajme
Poland Syndrome is a rare disease with an incidence of 1 in 30,000. This disease is characterized by agenesis of the pectoralis major, hypoplasia of mammarian tissue and the nipple complex, and limb abnormalities. The severe form of this disease can be associated with rib and sternal malformations like pectus excavatum. A 19-year-old man with severe Poland syndrome with cardiac extrasystoles and restrictive ventilation as shown by a spirometry test is presented. A total sternal reconstruction with partial osteotomies and bilateral resection of cartilage was performed...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28894923/differences-in-myocardial-strain-between-pectus-excavatum-patients-and-healthy-subjects-assessed-by-cardiac-mri-a-pilot-study
#18
André Lollert, Tilman Emrich, Jakob Eichstädt, Christoph Kampmann, Tariq Abu-Tair, Salmai Turial, Christoph Düber, Karl-Friedrich Kreitner, Gundula Staatz
OBJECTIVES: To evaluate differences in myocardial strain between pectus excavatum (PE) patients and healthy subjects (HS) assessed by cardiac MRI using the feature-tracking algorithm. METHODS: Cardiac MRI was performed in 14 PE patients and 14 HS (9:5 male to female in each group; age 11-30 years) using a 3T scanner. Post-examination analysis included manual biventricular contouring with volumetry and ejection fraction measurement by two independent radiologists...
September 11, 2017: European Radiology
https://www.readbyqxmd.com/read/28857528/-benefits-of-magnetic-resonance-for-the-study-of-pectus-excavatum-in-children-initial-experience
#19
M Dore Reyes, C De La Torre, M Bret Zurita, P Triana Junco, J Jiménez Gómez, M Romo Muñoz, A Vilanova Sánchez, M Parrón Pajares, A Pérez Vigara, J L Encinas Hernández, L Martínez Martínez, F Hernández Oliveros, M López-Santamaría
INTRODUCTION/AIM OF THE STUDY: In patients with PE, cardiovascular alterations ensue as a result of the mediastinum compression caused by sternum impingement and is responsible of many of the symptoms. Anatomical and functional assessment is of the utmost importance for a comprehensive understanding of the disease and an adequate treatment plan. Our aim was to describe the use of magnetic resonance image (MRI) in the study of PE and whether it is comparable to imaging techniques. PATIENTS AND METHODS: A retrospective study of the first 10 patients in which an MRI was performed as part of PE assessment within august 2015-2016...
April 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28852843/enhancing-recovery-after-minimally-invasive-repair-of-pectus-excavatum
#20
Cristen N Litz, Sandra M Farach, Allison M Fernandez, Richard Elliott, Jenny Dolan, Will Nelson, Nebbie E Walford, Christopher Snyder, Jeffrey P Jacobs, Ernest K Amankwah, Paul D Danielson, Nicole M Chandler
PURPOSE: There are variations in the perioperative management of patients who undergo minimally invasive repair of pectus excavatum (MIRPE). The purpose is to analyze the change in resource utilization after implementation of a standardized practice plan and describe an enhanced recovery pathway. METHODS: A standardized practice plan was implemented in 2013. A retrospective review of patients who underwent MIRPE from 2012 to 2015 was performed to evaluate the trends in resource utilization...
October 2017: Pediatric Surgery International
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