Wongi Woo, Duk Hwan Moon, Jimin Lee, Bong Jun Kim, Sungsoo Lee
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引用次数: 0
摘要
背景:乳房下垂微创修复术(MIRPE)可改善临床疗效和胸壁形态。然而,即使在手术后,胸肌下垂(PE)患者的不对称仍是一个重要问题。在此,我们评估了双杠技术在实现胸壁对称方面的益处:这项回顾性研究纳入了 2017 年至 2021 年间接受 MIRPE 的 79 例 PE 患者。患者被分为双杠组和非双杠组。不对称程度(AD)和胸骨旋转角度(SRA)用于根据计算机断层扫描(CT)图像评估不对称的严重程度。主要结果是放射学参数的变化。次要结果是临床结果,包括住院时间、疼痛评分和并发症发生率。对术前有不对称PE的患者进行了分组分析:结果:双杠组患者(23 人)比非双杠组患者(56 人)年轻。此外,双杠组患者的疼痛评分较低,住院时间较短。根据放射学评估,双杠组的 AD 下降幅度更大,但不影响哈勒指数(HI)的改善。在术前AD>5%的不对称患者中,双杠技术的优势更为明显,从而显著降低了AD。在这一亚组中,胸骨旋转的矫正效果更好:结论:双杠技术可能是矫正 PE 患者不对称的一个很有前途的选择。简化的 AD 和 SRA 放射学评估可用于评估胸壁构型的改善情况。
Double-bar technique for the correction of asymmetric pectus excavatum.
Background: Minimally invasive repair of pectus excavatum (MIRPE) improves clinical outcomes and chest wall morphology. However, asymmetry in patients with pectus excavatum (PE) remains as an important issue, even after surgery. Here, we evaluated the benefit of double-bar technique in achieving a symmetric chest wall.
Methods: This retrospective study included 79 patients with PE who underwent MIRPE between 2017 and 2021. The patients were divided into the double- or non-double-bar groups. Asymmetric degree (AD) and sternal rotation angle (SRA) were used to assess the severity of asymmetry based on computed tomography (CT) images. The primary outcome was the change in radiologic parameters. Secondary outcomes were clinical results, including hospital stay, pain scores, and complication rates. Subgroup analysis of patients with preoperative asymmetric PE was performed.
Results: Patients in the double-bar group (n=23) were younger than those in the non-double-bar group (n=56). Additionally, the double-bar group exhibited lower pain scores and shorter hospital stay. Based on radiological assessments, the double-bar group demonstrated a greater decrease in AD without compromising improvement in the Haller index (HI). The benefit of the double-bar technique was more obvious among patients with asymmetry with a preoperative AD >5%, resulting in a significant reduction in AD. In this subgroup, a better correction of sternal rotation was observed.
Conclusions: The double-bar technique may be a promising option for correcting asymmetry in patients with PE. Simplified AD and SRA radiologic assessments can be used to evaluate improvements in chest wall configuration.
期刊介绍:
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.