Publication: Pektus ekskavatum deformitesinde minimal invaziv onarım tekniği: Marmara deneyimi
Abstract
Amaç: Pektus ekskavatumun cerrahi tedavisinde minimal invaziv onarım tekniği giderek daha çok kabul görmekte, çocuklarda ve erişkinlerde başarıyla uygulanmaktadır. Bu çalışmada kliniğimizin pektus ekskavatum tedavisinde minimal invaziv onarım deneyimi değerlendirilmektedir. Hastalar ve Yöntemler: Ağustos 2005 - Kasım 2010 tarihleri arasında minimal invaziv onarım tekniği uygulanan 168 pektus ekskavatum olgusu retrospektif olarak incelendi. Olgular; genel demografik veriler, ameliyat endikasyonu, deformite şekli, ek anomali, aile öyküsü, önceki cerrahi düzeltmeler, bar sayısı, ameliyat süresi, ek girişim, analjezi yöntemi, perioperatuar ve postoperatuar komplikasyonlar, bar çekilmesi ve hasta memnuniyeti yönünden değerlendirildi. Bulgular: Olguların 141i erkek, 27si kadın, ortanca yaş 16 idi. 110 olguda deformite simetrik, 58inde asimetrikti. En sık rastlanan ek anomali 27 olguda görülen skolyozdu. 26 olguda ailede deformite öyküsü mevcuttu. 14 olguya daha önce açık cerrahi uygulanmıştı. Olguların 105inde 1, 58inde 2, 5inde 3 bar ile düzelme sağlanabildi. Ortanca operasyon süresi 60 dakika idi. En sık perioperatif komplikasyon 12 olguda gelişen pnömotorakstı. Geç dönemde en sık komplikasyon 8 olguda gelişen yara enfeksiyonuydu. 7 olguda planlanan sürenin sonuna barlar çekildi, 1 olgu dışında nüks görülmedi. Yaşam kalitesi anketlerinde olguların %94ünün tedaviden memnun olduğu görüldü. Sonuç: Minimal invaziv onarım, başarılı kozmetik sonuçları ve yüksek hasta memnuniyeti ile pektus ekskavatumda yüz güldürücü bir tedavi yöntemidir.
Objective: Minimally invasive repair of pectus excavatum (MIRPE) have gained support recently as it can be applied in both children and adults successfully Our objective was to review minimally invasive repair of pectus excavatum in Marmara University School of Medicine. Patients and Methods: One hundred and sixty eight cases who had minimally invasive repair between August-2005 and November-2010 were reviewed retrospectively. Cases were evaluated according to demographics, surgical indication, form of deformity, concommitant anomalies, family history, previous corrections, number of bars, duration of the operation, concommitant procedures, pain management, peri-and postoperative complications, bar removal, and patient satisfaction. Results: One hundred and forty one cases were male, 27 were female. Median age was 16. The deformity was symmetric in 110, asymmetric in 58 cases. The most common concommitant anomaly was scoliosis in 27 cases. 26 cases had a family history for deformity. 14 cases had a previous open repair. 1 bar in 105, 2 in 58, 3 in 5 cases were placed for correction. The median duration of the operation was 60 minutes. The most common perioperative complication was pneumothorax in 12 cases. The most common postoperative complication was wound infection in 8 cases. Bar removal was performed in 7 cases with only one recurrence. Quality-of-life questionnaires revealed that 94% of patients were satisfied with the treatment. Conclusion: This minimally invasive technique is a promising procedure for better cosmetic results and high levels of patient satisfaction.
Objective: Minimally invasive repair of pectus excavatum (MIRPE) have gained support recently as it can be applied in both children and adults successfully Our objective was to review minimally invasive repair of pectus excavatum in Marmara University School of Medicine. Patients and Methods: One hundred and sixty eight cases who had minimally invasive repair between August-2005 and November-2010 were reviewed retrospectively. Cases were evaluated according to demographics, surgical indication, form of deformity, concommitant anomalies, family history, previous corrections, number of bars, duration of the operation, concommitant procedures, pain management, peri-and postoperative complications, bar removal, and patient satisfaction. Results: One hundred and forty one cases were male, 27 were female. Median age was 16. The deformity was symmetric in 110, asymmetric in 58 cases. The most common concommitant anomaly was scoliosis in 27 cases. 26 cases had a family history for deformity. 14 cases had a previous open repair. 1 bar in 105, 2 in 58, 3 in 5 cases were placed for correction. The median duration of the operation was 60 minutes. The most common perioperative complication was pneumothorax in 12 cases. The most common postoperative complication was wound infection in 8 cases. Bar removal was performed in 7 cases with only one recurrence. Quality-of-life questionnaires revealed that 94% of patients were satisfied with the treatment. Conclusion: This minimally invasive technique is a promising procedure for better cosmetic results and high levels of patient satisfaction.