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Postoperative Complications After Minimally-Invasive Repair of Pectus Excavatum

Murat Oncel, Guven Sadı Sunam, Huseyın Yıldıran

Department of Thoracıc Surgery, Medıcal Faculty of Selcuk Unıversıty, Konya, Turkey

 

Background: Minimally invasive repair of pectus excavatum (MIRPE) is the procedure of choice in experienced centers.

Material and Method: Sixty-two patients underwent MIRPE at the Selcuk University Medical Faculty, Thoracic Surgery Division between 2011 and 2016. They were performed by two surgeons at same institutions. Twenty percent of all were used the Walter Lorenz bar. The mean age was 16 (6 to 36). Double pectus bar were used for 1 patient (1,6%). Lateral stabilizers were used in 18 patients (29%) on the left side, in 26 patients (42%) on right side. The mean Haller Index was 3,81. Patients mean blood loss was 10 ml (5ml to 60ml). Average of length of hospital stay was 4,4 days.

Results: There were no deaths, cardiac perforations, pericarditis, pneumonia. The most common complication was chronical pain at postoperative time (9.2%). Pneumothorax requiring tube thoracostomy was in 3,2%. Pneumothorax requiring simple aspiratıons was in 1 patient. The other problems were wound infection (1,6%), bar disposition (3,2%) and thoracic chondrodystrophy (as asymetric pectus carinatum) (3,2%).

Conclusion: We recommend performing MIRPE and removal of the pectus bar only in specialized institutions with high frequency of patients with pectus excavatum and with wide experience in thoracic surgery and the possibilities for the management of serious complications. This experience has demonstrated conclusively that pectus excavatum can be corrected with excellent longterm and minimally postoperative complications results without cartilage incision or resection and without sternal osteotomy.

Keywords: Complication, minimally invasive surgery, pectus excavatum