Radiological assessment of surgical treatment results in children and adolescents with pectus excavatum: medium-term results of 75 cases

Abstract

Objective — Minimally invasive repair of pectus excavatum (PE) has been established as the preferred technique for the repair of PE. Modified techniques of repair based on D. Nuss method for PE are promoted to improve the safety of the procedures. Purpose of this work was to analyzing the operative results with accounting of the toracometric parameters of pectus excavatum in children and adolescents. Methods — Toracometric parameters were the followings, as: sternum rotation, cardiac and pulmonary vein rotation angles, Haller and asymmetry indices in children and adolescents with PE. 48 (64%) patients are operated by D. Nuss procedure and 27 (36%) with modifications, due to severity of diagnostic parameters, which were exhibited the significance difference between pre- and postoperative indices, mainly, in patients who has a severe degree changes preoperatively. Results — The sternum rotation degree (in 75 patients) was decreased till 0.4±0.02° (P=0.01), whereas was 20.7±0.46° preoperatively (P=0.001). Preoperatively, the mean of cardiac rotation angle significantly reduced, preoperative was 56.0±2.9° (P=0.001) (in 75 patients) and after operative intervention made up 47.0±2.7° (P=0.001). Haller index also is decreased till 2.3±0.2, whereas was 3.9±0.2 preoperatively (P=0.002). The angle of the pulmonary vein rotation was preoperatively 51.0±3.4° (P=0.001) and after operation was increased till 53.0±1.8° (P=0.01). Conclusions — It has necessity apply the computer tomography investigation in patients with PE deformity. Also, it cannot miss the stage of the sterno-costal complex strength, its pliability and the gravity of the sternum rotation, which may lead to raise the share of good and excellent results.