Abstract
BackgroundSeveral 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.MethodsWe 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.ResultsOur study group consisted of 20 patients (mean age 19 years) who had bar explantation and our control group included 20 patients (mean age 16 years) prior to MIRPE. At the time of bar removal we detected significantly elevated concentrations of chromium and nickel in the tissue compared to patients prior to the procedure (p<0,001). We also found a significant increase in the levels of chromium in urine and nickel in blood in patients three years post MIRPE (p<0,001). Four patients temporarily developed symptoms of metal allergy, all had elevated metal values in blood and urine at explantation.ConclusionsMinimally-invasive repair of pectus excavatum can lead to a significant trace metal exposure.
Highlights
We evaluated the concentration with chromium, cobalt and nickel in blood, urine and tissue in patients prior to minimally-invasive repair of pectus excavatum (MIRPE) and in patients who underwent an explantation of the stainlesssteel bar(s) after three years
We found a significant increase in the levels of chromium in urine and nickel in blood in patients three years post MIRPE (p
Minimally-invasive repair of pectus excavatum can lead to a significant trace metal exposure
Summary
The minimally invasive repair of pectus excavatum (MIRPE) via the implantation of one or more metal bars has become the standard technique for correction of pectus excavatum morphology. Over the past ten years, several publications have reported a high incidence of local tissue reactions after MIRPE without clear signs of infection. These reactions occur in 6–8% of the cases and have been attributed to an allergic reaction to the metal bars implanted [7, 8]. 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
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