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Pigeon chest: comparative analysis of surgical techniques in minimal access repair of pectus carinatum (MARPC) 
 
Pigeon chest: comparative analysis of surgical techniques in minimal access repair of pectus carinatum (MARPC)
  Ancuta Muntean, Ionica Stoica, Amulya K. Saxena
 [Abstract] [Full Text] [PDF]   Pageviews: 932 Times
 
Background: After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair for pectus carinatum (MARPC) and compare the outcomes.
Data sources: Literature was reviewed on PubMed with the terms ¡°pectus carinatum¡±, ¡°minimal access repair¡±, ¡°thoracoscopy¡± and ¡°children¡±.
Results: Twelve MARPC techniques that included 13 articles and 140 patients with mean age 15.46 years met the inclusion criteria. Success rate of corrections was n = 125, about 89% in cumulative reports, with seven articles reporting 100%. The complication rate was 39.28%. Since the pectus bar is placed over the sternum and has a large contact area, skin irritation was the most frequent morbidity (n = 20, 14.28%). However, within the complication group (n = 55), wire breakage (n = 21, 38.18%) and bar displacement (n = 10, 18.18%) were the most frequent complications. Twenty-two (15.71%) patients required a second procedure. Recurrences have been reported in four of twelve techniques. There were no lethal outcomes.
Conclusions: MARPC techniques are not standardized, as MIRPE are, so comparative analysis is difficult as the only common denominator is minimal access. Surgical morbidity is high in MARPC and affects > 2/3rd patients with about 15% requiring surgery for complication management.
 
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World Journal of Pediatric Surgery

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