Early results of thoracic remodeling for patients with bar removal after pectus excavatum correction in minimal-procedure

Abstract

Objective To study thoracic re-remodeling and therapeutic effect after the bar removal for pectus excavatum corrected by minimal-invasive technique. Methods 145 cases with pectus excavatum, male 115, femal 30; adults in 59, children 86; corrected by minimal -invasive technique improved and performed by the same group surgeon. Bar removed 12-82 months after the procedure, appraising index of curative effects include in chest appearance, thoracic index, thoracic computer tomography(CT) and the distance between the behind of sternum to the anterior border of thoracic spine in the sagittal view. Results The chest shape was good. Thoracic index: before bar removal 2.36±0.32 in children, 2.60±0.45 in adults; after that, 2.77±0.44 in children, 3.04±0.56 in adults. There was all subsidence on the each point of the sternum, descent the maximum at the inferior end of the midsternum, (15.18±7.95)mm in children, (14.93±8.81)mm in adults, comparing with bar removal before and after. There was statistical significance. Not the signs of compressing the heart on the CT view. The time interval of the bar removed 3-year in children, 5-year in adults without affecting the development of the patients’ thorax. Conclusion The sternum descended slightly after bar removal when pectus excavatum corrected to expecting effects. After that, thoracic remodeling again, the chest shape well. Key words: Pectus excavatum Minimally invasive surgery Thoracic remodeling Early efficacy