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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 1999 February;40(1):139-46

language: English

The seagull ­wing self retaining pros­the­sis in the sur­gi­cal treat­ment of pec­tus exca­va­tum

Actis Dato G. M., Cavaglià M., Ruffini E. *, Actis Dato A. jr, Mancuso M. *, Parola A. *, Papalia E. *, Oliaro A. *

From the Italian Institution of Cardiac Surgery, Turin, Italy
* Department of Thoracic Surgery University of Turin, Turin, Italy


Background. Between June 1958 and June 1996 we oper­at­ed ­many ­patients affect­ed by pectus excavatum ­with an orig­i­nal sur­gi­cal tech­nique. In ­this ­study we eval­u­at­ed the dur­abil­ity of the ­results.
Methods. Experimental ­design: Retrospective ­study ­with a ­mean fol­low-up ­time of 15.8 ­years/pt, and 60% com­plete.
Setting: private and institutional prac­tice.
Patients or par­tec­i­pants: 357 ­patients (253 ­males and 104 ­females, ­mean age = 18.2±5.1 ­years) affect­ed by pec­tus exca­va­tum. The ­grade of PE (Chin clas­sifi­ca­tion) was I in 76 ­patients, II in 165 and III in the remain­ing 116. Most of the ­patients ­required oper­a­tion for aes­thet­ic rea­sons ­only (339 patients; 95%).
Intervention: the sur­gi­cal tech­nique con­sist­ed of a dou­ble trans­ver­sal ster­not­o­my at the lev­el of the low­est and high­est ­part of the depres­sion asso­ciat­ed ­with a lon­gi­tu­di­nal ster­not­o­my. A ­wedge resec­tion of the ­ribs was ­then per­formed and the ster­num was ­fixed ­using an orig­i­nal stain­less ­steel ­strut pros­the­sis mould­ed ­into a sea­gull ­wing. The ­strut was ­removed 12 ­months ­post-implan­ta­tion.
Results. There ­were no oper­a­tive ­deaths. Four ­patients (1.2%) had ster­nal ­wound infec­tion, ­which was suc­cess­ful­ly treat­ed. From the aes­thet­ic ­point of ­view, the ­post-oper­a­tive ­results ­were excel­lent in 262 ­patients (73.4%), ­good in 82 (22.9%) and ­poor in 13 (3.6%). All sub­jec­tive symp­toms, ­when ­present, dis­ap­peared ­after sur­gery.
Conclusions. The sea­gull ­wing pros­the­sis ­appears to be ­safe, ­easy to ­implant and to ­remove, and com­fort­able for the ­patient. This tech­nique has ­shown ­good ­long-­term ­results inde­pen­dent­ly of ­type of defor­mity and ­patient age.

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