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Pectus Excavatum Repair Using Autologous Perichondrium for Sternal Support

Pectus Excavatum Repair Using Autologous Perichondrium for Sternal Support Abstract • The support of the lower sternum following repair of pectus excavatum using autologous perichondrium from the lower costal cartilages to supplement the standard Ravitch's repair has been used effectively in 29 children during the past 14 years. This technique helps prevent recurrent sternal depression, particularly when the operation is performed in preadolescent children. Most adolescents and adults with pectus deformities as well as patients requiring reoperation will benefit from an internal prosthesis for the sternum that supplements the perichondrial support to reduce the frequency of subsequent sternal depression. Using the described operative technique, an excellent cosmetic and functional result was obtained in 27 children. Recurrent sternal depression of mild degree that occurred in two patients in the first four months postoperatively was related to trauma and possibly to decreased vascular supply to the lower sternum but neither required additional therapy. The internal mammary vessels should be preserved with the lower sternum whenever feasible. (Arch Surg 113:1433-1437, 1978) References 1. Brown AL: Pectus excavatum (funnel chest) anatomic basis: Surgical treatment of incipient stage in infancy; and correction of deformity in fully developed stage . J Thorac Surg 9:164-184, 1939. 2. Sweet RH: Pectus excavatum: Report of two cases successfully operated upon . Ann Surg 119:922-934, 1944.Crossref 3. Lester CW: The surgical treatment of funnel chest . Ann Surg 123:1003-1022, 1946.Crossref 4. Ravitch MM: Operative technique of pectus excavatum . Ann Surg 129:429-444, 1949.Crossref 5. Ravitch MM: Technical problems in the operative correction of pectus excavatum . Ann Surg 162:29-33, 1965.Crossref 6. Dailey JA: Repair of funnel chest using substernal osteoperiosteal rib graft strut: Report of case with four year follow-up . JAMA 150:1203-1204, 1952.Crossref 7. Brodkin HA: Congenital chondrosternal depression (funnel chest): Its treatment by phrenosternolysis and chondrosternoplasty . Dis Chest 19:288-306, 1951.Crossref 8. Brantigan OC: Pectus excavatum: Simple autogenous tissue support to keep sternum elevated . Am Surg 33:253-257, 1967. 9. Griffin EH, Minnis JF: Pectus excavatum: A survey and a suggestion for maintenance of correction . J Thorac Surg 33:625-636, 1957. 10. Rehbein F, Wernicke HH: The operative treatment of funnel chest . Arch Dis Child 32:5-8, 1957.Crossref 11. Paltia V, Parkkulainen KV, Sulamaa M, et al: Operative technique in funnel chest: Experiences in 81 cases . Acta Chir Scand 116:90-98, 1959. 12. Adkins PC, Blades B: A stainless steel strut for the correction of pectus excavatum . Surg Gynecol Obstet 113:111-113, 1961. 13. Jensen NK, Schmidt WR, Garamella JJ, et al: Pectus excavatum and carinatum: The how, when, and why of surgical correction . J Pediatr Surg 5:4-11, 1970.Crossref 14. Haller JA Jr, Katlic M, Shermeta DW, et al: Operative correction of pectus excavatum: An evolving perspective . Ann Surg 184:554-557, 1976.Crossref 15. Wada J, Akeda I, Ishida T, et al: Results of 271 funnel chest operations . Ann Thorac Surg 10:526-532, 1970.Crossref 16. Arnold M: The surgical anatomy of sternal blood supply . J Thorac Cardiovasc Surg 64:596-602, 1972. 17. Beiser GD, Epstein SE, Stampfer M, et al: Impairment of cardiac function in patients with pectus excavatum, with improvement after operative correction . N Engl J Med 287:267-272, 1972.Crossref 18. Liese W, Buhlmann AA: Work capacity and lung volumes before and after surgical correction of pectus excavatum . Schweiz Med Wochenschr 104:83-109, 1974. 19. Welch KJ, Treves S, Strieder D: Cardiopulmonary studies in children with pectus excavatum. J Pediatr Surg, to be published. 20. Bevegård S: Postural circulatory changes at rest and during exercise in patients with funnel chest, with special reference to factors affecting the stroke volume . Acta Med Scand 171:695-711, 1962.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Pectus Excavatum Repair Using Autologous Perichondrium for Sternal Support

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References (22)

Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1978.01370240055008
Publisher site
See Article on Publisher Site

Abstract

Abstract • The support of the lower sternum following repair of pectus excavatum using autologous perichondrium from the lower costal cartilages to supplement the standard Ravitch's repair has been used effectively in 29 children during the past 14 years. This technique helps prevent recurrent sternal depression, particularly when the operation is performed in preadolescent children. Most adolescents and adults with pectus deformities as well as patients requiring reoperation will benefit from an internal prosthesis for the sternum that supplements the perichondrial support to reduce the frequency of subsequent sternal depression. Using the described operative technique, an excellent cosmetic and functional result was obtained in 27 children. Recurrent sternal depression of mild degree that occurred in two patients in the first four months postoperatively was related to trauma and possibly to decreased vascular supply to the lower sternum but neither required additional therapy. The internal mammary vessels should be preserved with the lower sternum whenever feasible. (Arch Surg 113:1433-1437, 1978) References 1. Brown AL: Pectus excavatum (funnel chest) anatomic basis: Surgical treatment of incipient stage in infancy; and correction of deformity in fully developed stage . J Thorac Surg 9:164-184, 1939. 2. Sweet RH: Pectus excavatum: Report of two cases successfully operated upon . Ann Surg 119:922-934, 1944.Crossref 3. Lester CW: The surgical treatment of funnel chest . Ann Surg 123:1003-1022, 1946.Crossref 4. Ravitch MM: Operative technique of pectus excavatum . Ann Surg 129:429-444, 1949.Crossref 5. Ravitch MM: Technical problems in the operative correction of pectus excavatum . Ann Surg 162:29-33, 1965.Crossref 6. Dailey JA: Repair of funnel chest using substernal osteoperiosteal rib graft strut: Report of case with four year follow-up . JAMA 150:1203-1204, 1952.Crossref 7. Brodkin HA: Congenital chondrosternal depression (funnel chest): Its treatment by phrenosternolysis and chondrosternoplasty . Dis Chest 19:288-306, 1951.Crossref 8. Brantigan OC: Pectus excavatum: Simple autogenous tissue support to keep sternum elevated . Am Surg 33:253-257, 1967. 9. Griffin EH, Minnis JF: Pectus excavatum: A survey and a suggestion for maintenance of correction . J Thorac Surg 33:625-636, 1957. 10. Rehbein F, Wernicke HH: The operative treatment of funnel chest . Arch Dis Child 32:5-8, 1957.Crossref 11. Paltia V, Parkkulainen KV, Sulamaa M, et al: Operative technique in funnel chest: Experiences in 81 cases . Acta Chir Scand 116:90-98, 1959. 12. Adkins PC, Blades B: A stainless steel strut for the correction of pectus excavatum . Surg Gynecol Obstet 113:111-113, 1961. 13. Jensen NK, Schmidt WR, Garamella JJ, et al: Pectus excavatum and carinatum: The how, when, and why of surgical correction . J Pediatr Surg 5:4-11, 1970.Crossref 14. Haller JA Jr, Katlic M, Shermeta DW, et al: Operative correction of pectus excavatum: An evolving perspective . Ann Surg 184:554-557, 1976.Crossref 15. Wada J, Akeda I, Ishida T, et al: Results of 271 funnel chest operations . Ann Thorac Surg 10:526-532, 1970.Crossref 16. Arnold M: The surgical anatomy of sternal blood supply . J Thorac Cardiovasc Surg 64:596-602, 1972. 17. Beiser GD, Epstein SE, Stampfer M, et al: Impairment of cardiac function in patients with pectus excavatum, with improvement after operative correction . N Engl J Med 287:267-272, 1972.Crossref 18. Liese W, Buhlmann AA: Work capacity and lung volumes before and after surgical correction of pectus excavatum . Schweiz Med Wochenschr 104:83-109, 1974. 19. Welch KJ, Treves S, Strieder D: Cardiopulmonary studies in children with pectus excavatum. J Pediatr Surg, to be published. 20. Bevegård S: Postural circulatory changes at rest and during exercise in patients with funnel chest, with special reference to factors affecting the stroke volume . Acta Med Scand 171:695-711, 1962.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Dec 1, 1978

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