Email this article Comparative characteristics of the efficiency of different methods of operational treatment for pectus excavatum in children: a multicenter study
- Authors: Razumovsky A.Y.1,2, Alkhasov A.B.2, Razin M.P.3, Axel’rov M.A.4,5, Tsap N.A.6, Kirgizov I.V.7, Abushkin I.A.8, Slizovsky G.V.9, Skryabin E.G.4, Skobelev V.A.10, Yagovkin M.A.11, Nekrasova E.G.12, Satyvaldayev M.N.13, Molchanov A.V.11, Aprosimova S.I.7, Dudarev V.A.14, Malchevsky V.A.4, Broder I.A.13, Olenina N.V.15, Aleksandrova N.S.15, Kuzhelievsky I.I.9
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Affiliations:
- Russian Medical Research University named after N.I. Pirogov
- Children’s City Clinical Hospital No 13 named after N.F. Filatov
- Kirov State Medical University
- Tyumen State Medical University
- Tyumen Regional Pediatric Clinical Hospital No 2
- Ural State Medical University
- Central Clinical Hospital with a Polyclinic
- South-Ural State Medical University
- Siberian State Medical University
- Kirov Regional Pediatric Clinical Hospital
- Kirov Regional Center for Traumatology, Orthopedics and Neurosurgery
- Tyumen Regional Pediatric Clinical Hospital No. 2", Tyumen, Russia
- Tyumen Regional Pediatric Clinical Hospital No 1
- Krasnoyarsk State Medical University named after V.F. Voyno-Yasenetsky
- Ekaterinburg Regional Pediatric Clinical Hospital No 1
- Issue: Vol 6, No 1 (2018)
- Pages: 5-13
- Section: Original papers
- URL: https://bakhtiniada.ru/turner/article/view/7520
- DOI: https://doi.org/10.17816/PTORS615-13
- ID: 7520
Cite item
Abstract
Background. Congenital malformations of the chest are observed in 1%–4% of the population, and the most common among these is pectus excavatum (90%).
Aim. We aimed to conduct a retrospective multicenter study to compare the effectiveness of various methods of operative removal of pectus excavatum in children.
Material and methods. We retrospectively analyzed the results of the surgical treatment of funnel-like deformity of the thorax in children conducted in clinics of pediatric surgery in seven regions of Russia (1,226 patients). The ratio of boys to girls in the study population was 2.2:1. The study population was divided as per their age into the following groups: 4–7 years (n = 180, 14.7%), 8–14 years (n = 731, 59.6%), and > 14 years (n = 315, 25.7%). The average age at which most children were operated was 11.83 ± 1.24 years. All children underwent a standard preoperative laboratory examination, including a general blood test, urine tests, a biochemical blood test, a hemostasiogram; radiographic diagnostic methods were used with the calculation of the Gizycka index; functional methods of investigation, such as electrocardiography, spirography, and radioisotope scintigraphy of the lungs were also used. Children with second- or third-degree pectus excavatum underwent surgical treatment almost exclusively. The symmetrical forms of the pectus excavatum were more prevalent. In most cases, the main pathological course was complicated.
Results and discussion. The operated patients were divided into the following 3 groups: the first (n = 62): operations with the resection of the curved cartilages and external fixation of the sternum-rib complex (Bairov’s operation), the second (n = 374): thoracoplasty with the resection of warped cartilages using internal metal fixators by Timoshchenko, Ravitch, Paltia, Kondrashin), and the third (n = 790): minimally invasive operations without resection with internal fixation (Nuss operations: original and modified). In the first group, favorable results of surgical treatment were noted in 80.6% of the patients, satisfactory results were observed in 6.5%, unsatisfactory results were seen in 12.9%, and the overall effectiveness of operative correction was 87.1%. In the second group, good results of surgical treatment were recorded in 88% of the patients, satisfactory in 6.4%, and unsatisfactory in 5.6%; the overall efficiency of operative correction was 94.4%. In the third group, good results of surgical treatment were recorded in 95.3%, satisfactory in 3.8%, and unsatisfactory in 0.9%; the efficiency of operative correction was 99.1%.
Conclusion. Today, the authors consider acceptable the operations by Timoshchenko and Paltia for complex of indicators, the optimal operation is Nuss.
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##article.viewOnOriginalSite##About the authors
Aleksandr Yu. Razumovsky
Russian Medical Research University named after N.I. Pirogov; Children’s City Clinical Hospital No 13 named after N.F. Filatov
Email: 911157@mail.ru
MD, PhD, Professor, Correspondig Member of RAS, Head of the Department of Pediatric Surgery of Russian Medical Research University named after N.I. Pirogov, Chief of the Department of Thoracic Surgery Children’s of City Clinical Hospital No 13 named after N.F. Filatov
Russian Federation, 1, Ostrovityanova street, Moscow, 117997; 15, Sadovaya-Kudrinskaya street, Moscow, 123001Abdumanap B. Alkhasov
Children’s City Clinical Hospital No 13 named after N.F. Filatov
Email: 911157@mail.ru
MD, PhD, Professor, Thoracic Surgeon of the Department of Thoracic Surgery Children’s City Clinical Hospital No 13 named after N.F. Filatov
Russian Federation, 15, Sadovaya-Kudrinskaya street, Moscow, 123001Maksim P. Razin
Kirov State Medical University
Author for correspondence.
Email: mprazin@yandex.ru
MD, PhD, Professor, Head of the Department of Pediatric Surgery of Kirov State Medical University
Russian Federation, 112, K. Marksa street, Kirov, 610027Mikhail A. Axel’rov
Tyumen State Medical University; Tyumen Regional Pediatric Clinical Hospital No 2
Email: akselrov@mail.ru
MD, PhD, Head of the Department of Pediatric Surgery of Tyumen State Medical University, Chief of the Department of Pediatric Surgery No 1 Tyumen Regional Pediatric Clinical Hospital No 2
Russian Federation, 54, Odesskaya street, Tyumen, 625023; TyumenNatal’ya A. Tsap
Ural State Medical University
Email: tsapna-ekat@rambler.ru
MD, PhD, Professor, Head of the Department of Pediatric Surgery of Ural State Medical University
Russian Federation, 3, Repina street, Ekaterinburg, 620028Igor’ V. Kirgizov
Central Clinical Hospital with a Polyclinic
Email: kirgizov@yandex.ru
MD, PhD, Professor, Chief of the Department of Pediatric Surgery of Central Clinical Hospital with a Polyclinic
Russian Federation, 15, Marshala Timoshenko street, Moscow, 121356Ivan A. Abushkin
South-Ural State Medical University
Email: ivanabushkin@mail.ru
MD, PhD, Professor, Head of the Department of Pediatric Surgery of South-Ural State Medical University
Russian Federation, 64, Vorovsky street, Chelyabinsk, 454092Grigoriy V. Slizovsky
Siberian State Medical University
Email: gvs5858@mail.ru
MD, PhD, Head of the Department of Pediatric Surgery of Siberian State Medical University
Russian Federation, 2, Moscowski Trakt, Tomsk, 634050Evgeniy G. Skryabin
Tyumen State Medical University
Email: akselrov@mail.ru
MD, PhD, Professor, Professor of the Department of Traumatology, Orthopedics, Military Surgery of Tyumen State Medical University
Russian Federation, 54, Odesskaya street, Tyumen, 625023Valentin A. Skobelev
Kirov Regional Pediatric Clinical Hospital
Email: mprazin@yandex.ru
MD, PhD, Chief of the Department of Pediatric Surgery of Kirov Regional Pediatric Clinical Hospital
Russian Federation, KirovMikhail A. Yagovkin
Kirov Regional Center for Traumatology, Orthopedics and Neurosurgery
Email: mprazin@yandex.ru
MD, Head of the Kirov Regional Center for Traumatology, Orthopedics and Neurosurgery
Russian Federation, KirovElena G. Nekrasova
Tyumen Regional Pediatric Clinical Hospital No. 2", Tyumen, Russia
Email: tsapna-ekat@rambler.ru
Ekaterinburg
Russian Federation, Ekaterinburg Regional Pediatric Clinical Hospital No 1Mustakhim N. Satyvaldayev
Tyumen Regional Pediatric Clinical Hospital No 1
Email: akselrov@mail.ru
MD, Chief of the Department of Thoracic Surgery Children’s of Tyumen Regional Pediatric Clinical Hospital No 1
Russian Federation, TyumenAleksey V. Molchanov
Kirov Regional Center for Traumatology, Orthopedics and Neurosurgery
Email: mprazin@yandex.ru
MD, Chief of the Department of Pediatric of Kirov Regional Center for Traumatology, Orthopedics and Neurosurgery
Russian Federation, KirovSvetlana I. Aprosimova
Central Clinical Hospital with a Polyclinic
Email: kirgizov@mail.ru
MD, Children’s Surgeon of the Department of Pediatric Surgery of Central Clinical Hospital with a Polyclinic
Russian Federation, 15, Marshala Timoshenko street, Moscow, 121356Vadim A. Dudarev
Krasnoyarsk State Medical University named after V.F. Voyno-Yasenetsky
Email: kras@krasmed.ru
MD, PhD, Professor of the Krasnoyarsk State Medical University named after V.F. Voyno-Yasenetsky
Russian Federation, 1, P. Zeleznyaka street, Krasnoyarsk, 660022Vladimir A. Malchevsky
Tyumen State Medical University
Email: akselrov@yandex.ru
MD, PhD, Professor of the Department of Pediatric Surgery of Tyumen State Medical University
Russian Federation, 54, Odesskaya street, Tyumen, 625023Igor’ A. Broder
Tyumen Regional Pediatric Clinical Hospital No 1
Email: akselrov@mail.ru
MD, PhD, Vice-Head of the Tyumen Regional Pediatric Clinical Hospital No 1
Russian Federation, TyumenNatal’ya V. Olenina
Ekaterinburg Regional Pediatric Clinical Hospital No 1
Email: tsapna-ekat@rambler.ru
MD, Children’s Surgeon of the Department of Thoracic Surgery Children’s of Ekaterinburg Regional Pediatric Clinical Hospital No 1
Russian Federation, EkaterinburgNatal’ya S. Aleksandrova
Ekaterinburg Regional Pediatric Clinical Hospital No 1
Email: tsapna-ekat@rambler.ru
MD, Children’s Surgeon of the Department of Thoracic Surgery Children’s of Ekaterinburg Regional Pediatric Clinical Hospital No 1
Russian Federation, EkaterinburgIvan I. Kuzhelievsky
Siberian State Medical University
Email: 9111158@mail.ru
MD, PhD, Associative Professor of Department of Pediatric Surgery of Siberian State Medical University
Russian Federation, 2, Moscowski Trakt, Tomsk, 634050References
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