Comparative assessment of the results of treating pectus excavatum in children using various thoracoplastic techniques (long-term results)

Азизов М.Ж., Ходжанов И.Ю., Хакимов Ш.К., Хужаназаров И.Э., Мирзакаримов Б.Х., Касымов Х.А.

Abstract


Purpose of the present study consisted in making a comparative analysis of the long-term cosmetic and functional results after pectus excavatum (PE) correction using different techniques.
Materials and methods. The study was performed on the basis of analyzing the long-term results in 40 children with PE after performing correction using various techniques in different clinics. The main group included 20 children who underwent correction according to D. Nuss technique in the clinic of Scientific Research Institute of Traumatology and Orthopaedics (SRITO) of the Republic of Uzbekistan. To compare the results we selected the reference group of 20 children who underwent PE correction using G.A. Bairov and Ravich-Gross techniques in the clinic of the Andizhan Regional Children Multidisciplinary Hospital.
Results. The analysis was made comparatively in view of the subjective, objective, and the presented instrumental studies. In children of the main group a good cosmetic result was observed in 18 (90 %) cases with positive emotional spirit of the patients themselves and their parents that was significantly different (р less 0.01) from the data of the reference group where a good result was observed in 15 (75%) cases. Satisfactory results were noted in two (10%) cases in children from the main group only because of cheloid scars, and such a result in the reference group took place in three (15%) cases (р>0.05) where the zones with retraction parts were observed on the chest anterior surface in addition to cheloid scars. Unsatisfactory results as a funnel recurrence in children from the main group were observed in no cases. Such an outcome was registered in two (10%) cases in children from the reference group, as well as preservation of sternum pathological rotation, significant gross cheloid scars with uneven parts of the chest surface. The functional parameters by spirogram were significantly within the norm in children from the main group, and the disorder of external respiration function (ERF) by restriction type was preserved in the reference group (р less 0.001).
Conclusion. Thus, the data of the comparative analysis of the long-term comparative results demonstrated the superior cosmetic and functional results when using D.Nuss technique and its modifications comparing with the external traction techniques. The internal plate used by us allowed increasing the chest volume almost instantly, eliminating all the components of the funnel-shaped defect, and creating a normal anatomical shape with the appropriate effects positive for patients’ organism.

Keywords


children, pectus excavatum, thoracoplasty, D. Nuss technique, G.A. Bairov and Ravich-Gross techniques

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