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Surgery to the anterior chest wall: pectus carinatum and excavatum

On 12/11/2018
Article viewed 97 times

Surgery to the anterior chest wall: pectus carinatum and excavatum

By Pierre Lascombes (1), Jim Wilde (2), Isabelle Ruchonnet- Métrailler(3) in category TECHNIQUE
1- Service d’orthopédie pédiatrique / 2- Service de chirurgie pédiatrique / 3- Unité de pneumologie pédiatrique, Hôpitaux Universitaires de Genève

Numerous consultations are requested for children and adolescents because of anterior chest wall deformities, which is why in 2014, we began to hold multidisciplinary consultations in pectus excavatum (PE), pectus carinatum (PC) and other asymmetries of the ribcage where there is no clear association with a spinal deformity.

Numerous consultations are requested for children and adolescents because of anterior chest wall deformities, which is why in 2014, we began to hold multidisciplinary consultations in pectus excavatum (PE), pectus carinatum (PC) and other asymmetries of the ribcage where there is no clear association with a spinal deformity (1).

Our population base is French-speaking Switzerland that has around 2 million inhabitants. To date, we have formed a cohort of 110 patients, 49 PE and 61 PC, which has, over these first four years, consisted of 64 cases managed conservatively (39 dynamic compression braces in PC and 25 vacuum bells in PE) and 10 surgical interventions.

Since the beginning, we included in this multidisciplinary process, paediatricians from various fields with the aim of detecting the associated abnormalities and drawing up a complete report: it is other conditions that transform these deformities into a syndrome.

  • A respiratory specialist to assess lung function (one case of pulmonary deformity, while chest pain and dyspnoea on exertion were reported in 48% of PC and 12% of PE),
  • A cardiologist to assess cardiac function (one case of interatrial communication that was not previously known)

The purpose of this article is simply to describe our surgical techniques. Each...

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