Features of optimization of surgical treatment for pectus excavatum using thoracometry
Background. Pectus excavatum is the most common of all congenital chest anomalies. The degree and nature of chest deformity in children and adults is determined using the method of thoracometry, which gives an idea of the depth of deformation and the width of the chest, its oblique sizes, thoracic index, and also allows you to monitor these indicators in dynamics. The purpose of the study was to analyze the results of surgical treatment for pectus excavatum using the Nuss procedure and to determine ways to optimize treatment using thoracometry. Materials and methods. The study presents the results of the examination and treatment of 85 patients with pectus excavatum, among which 58 individuals underwent surgery according to the Nuss method (in 2017–2019) and 27 patients underwent removal of fixation devices from the sternum (operated using the Nuss procedure in 2016). Results. Among 27 patients who underwent correction of pectus excavatum according to the Nuss method in 2016, the result was positive in 24 (89.9 %) people: the difference during inspiration and expiration in terms of the sagittal and oblique sizes of the chest did not exceed 1 cm, and corresponded to the physiological norm. I. Gizycka index in the postoperative period was observed in the range of 0.82–1.0, which indicates a good correction of the shape of the chest. Three (11.1 %) patients reported a negative result: in 2 cases, pectus excavatum recurred, which required repeated surgery, and one patient had pectus carinatum. Among 58 patients operated primarily in 2017–2019, in 55 (94.8 %) individuals a good result was obtained, and 3 (5.2 %) patients had an unsatisfactory result, which manifested itself in a twist of the fixation device. Conclusions. Thoracometric examination in patients with pectus excavatum allows evaluating the results of surgical treatment at different times after surgery, to determine the degree of loss of deformity correction in comparison with the state immediately after surgery.
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