• Journal of Chest Surgery
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• v.23 no.2
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• pp.316-324
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• 1990

This study is a review of the early postoperative results in fifteen patients who diagnosed funnel chest and underwent the corrective surgical procedure by the sternal turnover[STO] or the sternocostal elevation[SCE] between January 1988 and February 1990. Thirteen among fifteen patients were male. Early eight patients were corrected by the STO and late seven patients by the SCE. Cosmetic result was excellent in one, fair in five, poor in two patients who received the STO and excellent in all patients corrected by the SCE. This unfavorable postoperative result in the STO group was due to the protrusion of inverted xiphisternal joint, the depression along the rejoined costal cartilages and forward tilting of the distal sternum. The lower vertebral indices measured on the lateral chest film were improved postoperatively from 0.42\ulcorner0.08 to 0.30\ulcorner0.05 in the STO group and from 0.31\ulcorner0.05 to 0.24\ulcorner0.03 in the SCE group. There was significant improvement in lower vertebral index in both groups, but it was difficult to compare the postoperative improvement between groups due to the different preoperative status. In the SCE group, the funnel index and the degree of depression measured on the computed tomography were significantly improved from 5.29\ulcorner1.72 and 3.11\ulcorner0.71 to 2.77\ulcorner0.46 and 1.63\ulcorner0.19[P<0.05], but there was no significant change in the degree of flatness postoperatively. This results suggest that sternocostal elevation is more cosmetic procedure than sternal turnover in children and in young adolescents whose funnel index measured on the computed tomography is low.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.21-26
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• 1982

Fourteen cases of funnel deformity, 11 were male and the others female, treated over a eleven-year period, are presented. The overall results with the methods described by the authors, Wada, Shannon, Adkins and Ravitch appear to be excellent. The symmetric depression was more common In children under the age of 12 years and asymmetric one Increased after the age of 12. Six cases of abnormal cardiac auscultatory findings revealed no consistent hemodynamic abnormalities. An 21-year-old female was associated with left lung agenesis and dextroversion of the heart, and a 6-year-old boy with congenital bronchogenic cyst who underwent right upper lobectomy. EKG changes associated with the anomaly were observed in all. Pulmonary function test showed the range from normal to moderate restriction which did not Improve in only one patient after operation, but the patient did not complain any restriction In activity. Some transient complications were developed which resulted in improvement.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.712-718
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• 1991

The pectus excavatum or funnel shaped thorax is a relatively frequent malformation of the chest wall which composed of depressed sternum and costal cartilage. The so-called sternal turnover operation for pectus excavatum has been disappointing due to postoperative complication such as fistula formation with necrosis of bone and muscle. Thus, the need of preserved vascular pedicle to sternum was stressed in this type of operation, keeping the bilateral internal mammary vessels preserved. We have experienced two cases of modified sternal turnover in children and obtained satisfactory postoperative results.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.65-68
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• 1995

Pectus excavatum occasionally occurs in patients who have underlying cardiac disease, especially Marfan syndrome. This report describes a patient with pectus excavatum who had ascending aortic aneurysm with aortic regurgitation and anterior leaflet prolapse of mitral valve. This patient underwent replacement of aortic valve and ascending aorta with 25 mm SJM valved conduit graft[Bentall operation with Cabrol shunt , and mitral valve replacement with SJM 31 mm, the pectus excavatum was corrected at the time of completion of the intracardiac operation with the modified sternal turnover. This procedure offered excellent operative exposure for the inracardiac operation with prevention of low cardiac output after operation due to depressed sternum and maintained chest wall stability resulting good cosmetic chest wall appearance. This patient recovered and discharged in good postoperative result with minimal temporary peroneal nerve palsy in his left leg.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.536-538
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• 2004

There are still some controversies regarding one stage repair of pectus deformity with congenital heart disease due to probable complications after extensive resection of deformed cartilages. We performed Nuss operation with simul-taneous intracardiac repair in 8 year old patient with pectus excavatum and partial atrioventricular septal defect. The result of operation was satisfactory without prolongation of operation time, bleeding or instability of chest wall.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.839-841
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• 2002

Generally, patients who have airway compression with severe kyphoscoliosis can be improved through surgery for the thoracolumbar deformity. However, abnormal thoracic configuration due to severe kyphoscoliosis can cause respiratory distress secondary to severe compression of central airway in uncorrectable case. We tried to elevate the chest wall and obtained relatively good result in case of airway compression with abnormal thoracic configuration which was difficult to correct.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.699-706
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• 1986

We have experienced 5 cases of Pectus excavatum corrected by Ravitch method without use of K-wire or metal bar from Jan. 1985 to Apr. 1986. All cases were male. The symmetric depression was in 4 cases, asymmetric one was in one case. The chief complaints were dyspnea on exertion, frequent U.R.I. and inferiority. The flail chest was developed in all cases, but it was insignificant in all cases except one who needed assist ventilation. Mediastinitis was developed in one case one week postoperatively but well managed with drainage. A distance from the posterior surface of sternum to the anterior surface of vertebral body was estimated preoperatively and postoperatively. Postoperative result was evaluated as the change of distance postoperatively. The change was 1.5cm minimally to 3.5cm maximally. Late results were "Excellent" in 3 cases and "Good" in 2 cases.uot; in 2 cases.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.391-398
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• 1986

From Jan. 1983 to Dec. 1985, seven cases of pectus excavatum, six were male and one female, were underwent an operation at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital. The ages of patients ranged from 6 to 27 years. They all had symptoms of feeling inferiority about chest deformity. The concavity on the funnel chest varied in its extent, and the severity, which was measured by water volume filled into it, varied from 59.5cc/m2 to 129.9cc/m2. All but one patients were approached through a bilateral transverse submammary incision and one approached through a vertical midline incision. Successful surgical correction required resection of all deformed costal cartilages with transverse anterior osteotomy and internal fixation using retrosternal metal bar. No serious complication have followed the use of this technique, but minor complications such as serous accumulation, pneumothorax and strut migration have been experienced. All patients were satisfactory about the surgical results.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.214-217
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• 2016

Pectus arcuatum is a rare complex chest wall deformity. A 31-year-old female presented with a severely protruding upper sternum combined with a concave lower sternum. We planned a modified Ravitch-type operation. Through vertical mid-sternal incision, chondrectomies were performed from the second to fifth costal cartilages, saving the perichondrium. Horizontal osteotomy was performed in a wedge shape on the most protruding point, and followed by an additional partial osteotomy at the most concaved point. The harvested wedge-shape bone fragments were minced and re-implanted to the latter osteotomy site. The osteotomized sternum was fixed with multiple wirings. With chondrosternoplasty, a complex chest wall deformity can be corrected successfully.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.695-699
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• 1994

Pectus excavatum. the most common congenital chest wall deformity, is manifested by deformity of the costal cartilages resulting in a depressed and often rotated sternum. Surgical correction of this disease is frequently indicated for aesthetic improvement. The most popular current repair involves resection of abnormal costal cartilages, sternal osteotomy and mobilization, followed by fixation of the sternum in the corrected position.12 patients have been operated upon for pectus excavatum by the Adkins` method for 8 years in our hospital and the results were as follows: 1. All the patients were male. Age distribution was 2-26 years[average 10.8 years] and 69.2% were below 7 years. 2. The deformity was found at neonate or infant in the most of the patients [92.3 %] 3. The subjective symptoms were frequent URI[35.7%], dyspena on exertion[21.4%], chest dis comfort[7.1%], asthma [7.1%] and most of the patients didn`t like their appearance. 4. Combined diseases were urticaria in 2 cases, bilateral cryptomhism and pulmonary tuberculosis in 1 case each other. 5. Welch index ranged from 1.7 to 5.0 with the average of 3.47. 6. Postoperative complications were pneumothorax [45.5%], wound infection [36.4%] and skin necrosis [18.2%]. Although the period of follow-up was short in some cases there was no relapse.