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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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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