Abstract
<i>Introduction:</i> Funnel chest deformation (FCHD) is the most common malformation of the chest. This anomaly appears as the cosmetic and functional disorders of the cardiovascular and respiratory systems. Its main characteristic feature is tendency to progression, closely linked with the growth and age of children. <i>Purpose:</i> To analyze results of surgical treatment at the children with FCHD, using minimally invasive method of thoracoplasty. <i>Materials and methods:</i> The research group included 21 children with FCHD at the age from 4 to 17 years. Symmetrical shape of deformation was revealed in 14 patients (66.6%), the asymmetric shape was revealed in 5 (23.8%) patients, the FCHD – in 2 children (9.5%). Preoperative examination included: routine clinical laboratory research, spirography, electrocardiography, echocardiography, chest radiography in the frontal and lateral projections and computed tomography. All patients underwent thoracoplasty with using method D. Nuss. <i>Results:</i> The period of supervision covered from 6 months to 4 years after surgery operation. Good results were obtained in 17 (80.96%) cases; satisfactory – in 3 cases (14.28%), unsatisfactory – in 1 case (4.76%). <i>Conclusion:</i> Surgical treatment of FCHD with using innovative in Ukraine method of retrosternal metal fixators – is vital importance direction in thoracoplasty, having numerous advantages, compared with resection techniques, as well as minimally invasive and a good cosmetic effect.
Highlights
Funnel chest deformation (FCHD) is the most common malformation of the chest
Characteristic feature of FCHD is tendency to progression, which is closely linked with a growth and age of children
In all examined children have been revealed: polysystemic lesions of connective tissue at least in two systems, at 2/3 of the given patients polysystemic lesions were observed in three systems, 19.04% of patients having polysystemic lesions in four systems of the human body
Summary
FCHD is the most typical malformation of chest, which covers 91% of all congenital chest deformations, according to the review of different authors [1, 5]. The following method for performing the operation was devised: (1) cutting the deformed sternum at the second intercostal position; (2) cutting the second costal cartilages to allow a repositioning of the vascular pedicle onto the presternal surface; (3) turning the sternum over, placing one end on the other, and attaching one end to the other; and (4) making a groove in the turned-over sternum to prevent the decussated vascular pedicle from becoming constricted By using this method, it is possible to keep the bilateral internal thoracic vessels intact. The internal mammary vessels were carefully dissected upward and downward each for 5 cm and the funnel shaped sternum was turned over for 180 degrees with care being exercised not to injure the blood vessels Author recommended this technique the first choice for the repair of pectus excavatum. Our research aimed to analyze results of the surgical treatment of FCHD at the children with using minimally invasive method of thoracoplasty
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