Pectus excavatum is a wall deformity that often warrants medical evaluation. In most cases, it's a purely visual aesthetic alteration, while in others, it comes with symptoms. Several surgical techniques have been described, but their outcomes are difficult to assess due to the heterogeneity of presentations and the lack of long-term follow-up. We present our experience as thoracic surgeons, assessing correction as either structural (remodeling of the thoracic cage through open surgery) or aesthetic (design and implantation of a customized 3D prosthesis).
Material and methods
Retrospective observational study of the indication for surgical treatment of pectus excavatum carried out by a team of thoracic surgeons and the short- to mid-term results.
Results
Between 2021 and 2023, we treated 36 cases surgically, either through thoracic cage remodeling techniques or with 3D prostheses. There were few minor complications, and the short- to mid-term results were positive: alleviation of symptoms or compression of structures when present, or aesthetic correction of the defect in other cases.
Conclusions
Surgery for pectus excavatum should be evaluated for structural correction of the wall or aesthetics. In the former, thoracic cage remodeling requiring cartilage excision and possibly osteotomies is necessary. In the latter, the defect is corrected with a customized 3D prosthesis.
导言开胸是一种胸壁畸形,通常需要进行医学评估。在大多数情况下,它只是一种纯粹的视觉美学改变,而在另一些情况下,它还伴有症状。目前已有几种手术方法,但由于表现的异质性和缺乏长期随访,其效果很难评估。我们作为胸外科医生介绍了我们的经验,将矫正评估为结构性矫正(通过开放手术重塑胸廓)或美学矫正(设计并植入定制的 3D 假体)。材料和方法由胸外科医生组成的团队对开胸手术治疗的适应症和中短期效果进行了回顾性观察研究。结果在 2021 年至 2023 年期间,我们通过胸廓重塑技术或 3D 假体手术治疗了 36 例患者。很少出现轻微并发症,中短期效果良好:症状减轻或结构受压,其他病例的缺损得到美学矫正。对于前者,需要进行胸骨笼重塑,切除软骨,可能还需要截骨。对于后者,可通过定制的三维假体矫正缺损。
{"title":"Pectus excavatum. Tratamiento quirúrgico: ¿estructural o estético?","authors":"José Marcelo Galbis Caravajal , Miriam Estors Guerrero , Nestor Martinez Hernández","doi":"10.1016/j.ciresp.2024.02.003","DOIUrl":"10.1016/j.ciresp.2024.02.003","url":null,"abstract":"<div><h3>Introduction</h3><p><em>Pectus excavatum</em> is a wall deformity that often warrants medical evaluation. In most cases, it's a purely visual aesthetic alteration, while in others, it comes with symptoms. Several surgical techniques have been described, but their outcomes are difficult to assess due to the heterogeneity of presentations and the lack of long-term follow-up. We present our experience as thoracic surgeons, assessing correction as either structural (remodeling of the thoracic cage through open surgery) or aesthetic (design and implantation of a customized 3D prosthesis).</p></div><div><h3>Material and methods</h3><p>Retrospective observational study of the indication for surgical treatment of <em>pectus excavatum</em> carried out by a team of thoracic surgeons and the short- to mid-term results.</p></div><div><h3>Results</h3><p>Between 2021 and 2023, we treated 36 cases surgically, either through thoracic cage remodeling techniques or with 3D prostheses. There were few minor complications, and the short- to mid-term results were positive: alleviation of symptoms or compression of structures when present, or aesthetic correction of the defect in other cases.</p></div><div><h3>Conclusions</h3><p>Surgery for <em>pectus excavatum</em> should be evaluated for structural correction of the wall or aesthetics. In the former, thoracic cage remodeling requiring cartilage excision and possibly osteotomies is necessary. In the latter, the defect is corrected with a customized 3D prosthesis.</p></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic and robotic distal pancreatectomy: Outcomes and the need for patient-centred evaluation","authors":"Adwaith Krishna Surendran , Srisanjith Girish , Chellappa Vijayakumar","doi":"10.1016/j.ciresp.2024.01.011","DOIUrl":"https://doi.org/10.1016/j.ciresp.2024.01.011","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.ciresp.2023.08.005
Sara Sofia S. Rodrigues , Daniela Ester Ribeiro , Miguel Costa , Marta Tavares
{"title":"Juvenile polyp","authors":"Sara Sofia S. Rodrigues , Daniela Ester Ribeiro , Miguel Costa , Marta Tavares","doi":"10.1016/j.ciresp.2023.08.005","DOIUrl":"https://doi.org/10.1016/j.ciresp.2023.08.005","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.ciresp.2023.11.009
Alba Correa Bonito , Carlos Cerdán Santacruz , Gianluca Pellino , Tamara Fernández Miguel , Elena Bermejo Marcos , Ana Rodríguez Sánchez , Javier García Septiem , Elena Martín-Pérez
Introduction
Management of patients diagnosed of acute uncomplicated diverticulitis has evolved lately and according to the latest guidelines, outpatient treatment and management without antibiotherapy may be used in selected patients. The aim of this study is to evaluate the adhesion among national centres to these and others recommendations related to this pathology.
Methods
An online national survey, that has been broadcast by several applications, was performed. The results obtained were statistically analysed.
Results
A total of 104 surgeons participated, representing 69 national hospitals. Of those, in 82.6% of the centers, outpatient management is performed for acute uncomplicated diverticulitis. 23.2% of the hospitals have a protocol stablished for treatment without antibiotherapy in selected patients. Centers that do not follow these protocols allege that the mean reasons are the logistic difficulties to set them up (49.3%) and the lack of current evidence for it (44.8%). Significative statistical differences have been found when comparing the establishment of such protocols between centers with advanced accredited units and those who are not, with higher rates of outpatient management and treatment without antibiotics in accredited units (P≤.05).
Conclusions
In spite that this a very common disease, there is a huge national heterogeneity in its treatment. This is why it would adviseable to unify diagnostic and treatment criteria by the collaboration of scientific societies and the simplification of the development of hospitalary protocols.
{"title":"Resultados de una encuesta nacional sobre el manejo de los pacientes diagnosticados de diverticulitis aguda no complicada","authors":"Alba Correa Bonito , Carlos Cerdán Santacruz , Gianluca Pellino , Tamara Fernández Miguel , Elena Bermejo Marcos , Ana Rodríguez Sánchez , Javier García Septiem , Elena Martín-Pérez","doi":"10.1016/j.ciresp.2023.11.009","DOIUrl":"10.1016/j.ciresp.2023.11.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Management of patients diagnosed of acute uncomplicated diverticulitis has evolved lately and according to the latest guidelines, outpatient treatment and management without antibiotherapy may be used in selected patients. The aim of this study is to evaluate the adhesion among national centres to these and others recommendations related to this pathology.</p></div><div><h3>Methods</h3><p>An online national survey, that has been broadcast by several applications, was performed. The results obtained were statistically analysed.</p></div><div><h3>Results</h3><p>A total of 104 surgeons participated, representing 69 national hospitals. Of those, in 82.6% of the centers, outpatient management is performed for acute uncomplicated diverticulitis. 23.2% of the hospitals have a protocol stablished for treatment without antibiotherapy in selected patients. Centers that do not follow these protocols allege that the mean reasons are the logistic difficulties to set them up (49.3%) and the lack of current evidence for it (44.8%). Significative statistical differences have been found when comparing the establishment of such protocols between centers with advanced accredited units and those who are not, with higher rates of outpatient management and treatment without antibiotics in accredited units (<em>P</em>≤.05).</p></div><div><h3>Conclusions</h3><p>In spite that this a very common disease, there is a huge national heterogeneity in its treatment. This is why it would adviseable to unify diagnostic and treatment criteria by the collaboration of scientific societies and the simplification of the development of hospitalary protocols.</p></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139887320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.ciresp.2024.02.001
Espin Alvarez Francisco , García-Domingo María Isabel , Cremades Pérez Manel , Cugat Andorra Esteban
{"title":"Laparoscopic and robotic distal pancreatectomy: the choice and the future","authors":"Espin Alvarez Francisco , García-Domingo María Isabel , Cremades Pérez Manel , Cugat Andorra Esteban","doi":"10.1016/j.ciresp.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.ciresp.2024.02.001","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140349848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.ciresp.2024.02.002
Miguel Pera
{"title":"Anastomotic leak in colorectal cancer surgery: Short term outcomes have long term consequences","authors":"Miguel Pera","doi":"10.1016/j.ciresp.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.ciresp.2024.02.002","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.ciresp.2023.06.003
Fernando Fernández López, Manuel Bustamante Montalvo
{"title":"Incarceración gástrica. Una complicación infrecuente de la hernia paraestomal","authors":"Fernando Fernández López, Manuel Bustamante Montalvo","doi":"10.1016/j.ciresp.2023.06.003","DOIUrl":"10.1016/j.ciresp.2023.06.003","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}