• Journal of Chest Surgery
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• v.35 no.7
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• pp.556-559
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• 2002

The presense of pectus excavatum in Marfan's syndrome may complicate cardiac operation by making midline sternotomy technically more difficult and limiting the operative exposure of the heart. We operated on a 33 year old male patient with Marfan's syndrome and severe pectus excavatum who had severe mitral regurgitation and moderate aortic regurgitation with 52mm aortic root dilation. The operative field was adequately exposed through a midline sternal incision with two sternal retactors. The patient underwent Bentall operation and mitral valve replacement. The repair of pectus excavatum was performed after completion of CPB and the administration of protamin. Permanent internal stabilization achieved by overlapping of the ends of lower ribs and reinforced with sternal closure wire.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.787-790
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• 1993

The purpose of this study is to analyze the early results by the operative methods in 36 patients with pectus excavatum during the period August 1989 to August 1993. We underwent Ravitch`s operation in 15 patients [mean age : 11.0], which consists of subperichondral resection of all deformed cartilages, anterior wedge osteotomy and fixation in place with wire sutures of the sternum, and sternal eversion operation in 21 patients[mean age : 5.3], which consists of en-bloc resection of deformed sternum and cartilages, tailoring of the costal cartilages and shaping of the sternum and fixation of sternum and cartilages. Early results were satisfactory in 93% [Excellent 93%] for Ravitch`s operations and in 100% [Excellent 90% and Good 10%] for sternal eversion operations. But late results by sternal growth will be necessary longer follow-up.

• Korean Journal of Veterinary Service
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• v.35 no.3
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• pp.251-254
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• 2012

Pectus excavatum (PE) is a ventral chest wall deformity, also known as funnel chest, sunken chest, chondrosternal depression or koilosternia. The 4 months old, 1.3 kg intact-female Pekingese dog was evaluated for acute semicoma and convulsion. The client reported that this patient have had chronic loss of appetite, intermittent dyspnea and palpable sunken breast. The other littermates did not show any abnormalities. On physical examination, cachexia (BCS 1/5), concave sternum, flatten thoracic cavity and cardiac murmur were observed. On radiographic study, the caudal sternum cave to vertebrae and narrowing thoracic cavity. The severities of thoracic deformity were evaluated by deformation indices such as-Frontosagittal index (FSI) and vertebral index (VI). Moderate to severe PE was founded by the radiological measurements.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.286-290
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• 1998

The pectus excavatum is the most common deformity of chest wall. The most common cause of surgical correction is cosmetic problem. From January 1981 to July 1996, 24 patients had undergone surgery for pectus excavatum and they were corrected by Ravitch operation(n=4) or modified Wada operation(n=20) respectively. We analyzed each surgical cases according to age, sex, chief complaint, degree of deformity, EKG findings, complications and satisfaction degree of patient. In some cases, we measured Welch index preoperatively and postoperatively. The postoperative complications were wound infection in two, pneumothorax in two and reccurrence in one. The average value of Welch index was significantly improved from 5.86$\pm$0.51 preoperatively to 4.10$\pm$0.51 postoperatively(P<0.05). The results by Humphreys' criteria were satisfiable in 88%(excellent 71%, good 17%). The findings of this study suggest that surgical correction of pectus excavatum with modified Wada rocedure and submammary s in incision is effective method in physical and psychiatric aspect.

• Journal of Chest Surgery
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• v.56 no.4
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• pp.229-237
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• 2023

Background: We aimed to demonstrate the advances we have achieved in pectus excavatum surgery over the last 10 years, with a particular focus on the refinement of pectus bar stabilization techniques and devices. Methods: In total, 1,526 patients who underwent minimally invasive repair of pectus excavatum surgery from 2013 to 2022 were enrolled and analyzed. We have pursued a new paradigm of crane-powered remodeling of the entire chest wall. The method of bar stabilization has changed from claw fixators to hinge plates and, finally, to bridge plate connections. We also evaluated the effectiveness of the hinge plate (group H) and the bridge plate (group B). Results: The bar displacement rates were 0.1% (n=2) for the claw fixator, 0% for the hinge plate (n=0), and 0% for the bridge plate (n=0). We stopped using the claw fixator in 2022 and the hinge plate in 2019. Since 2022, when we shifted to a multiple-bar technique for all patients, the bridge plate has replaced both the claw fixator and the hinge plate. No bar displacement occurred in either group. Group H had more pleural effusion, wound problems (p<0.05), and longer stays (5.5 vs. 6.2 days, p=0.034) than group B. Conclusion: We have made significant progress in pectus repair surgery over the last decade, particularly in stabilizing the pectus bar and reducing perioperative complications. Our current strategy is the multiple-bar approach with bridge stabilization. Since the bridge-only technique resulted in no bar displacement, we could eliminate the invasive claw fixator or hinge plate.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.167-172
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• 2001

배경: 누두흉은 앞가슴 기형 중 가장 흔하며 Meyer 등이 1911년 수술적 교정을 시행한 이래로 많은 술식들이 개발되어 왔다. 이들의 대부분은 전흉벽에 상처를 내고 늑연골을 자르는 과정이 필요하였다. 그러나 Nuss 등에 의해서 상기 과정없이 작은 옆가슴의 상처와 stainless steel bar로 흉골의 기형을 교정하는 국소침습적 방법이 개발되었다. 대상 및 방법: 1999년 11월부터 2000년 7월까지 누두흉의 교정을 원하는 환자 14예를 대상으로 하였다. 수술은 15세미만에서는 pectus bar를 1개를 사용하였고 그 이상에서는 2개를 사용하여 교정하였다. 결과: 남자는 11예, 여자는 3예 였으며 나이는 2세에서 52세 사이였다. 누두흉 지표는 5.3$\pm$1.84였고 비대칭지표는 1.06$\pm$0.03이였다. 수술 후 2일째 모두 일반병실로 올라갔다. 평균 재원기간은 4.2일이였다. 술후 합병증으로 성인에서 기흉 1예, 혈흉 1예, 그리고 나중에 발생한 흉막액 1예가 있었다. 결론: 누두흉에서 Nuss 술식으로 좋은 결과를 얻었다. 성인에서도 bar 2개를 이용하여 교정이 가능하였으나 소아에 비하여 합병증이 많이 발생하였는데 이는 성인에서 근육이 발달되어 있고, 뼈의 골화가 다 진행되었기 때문이다.

• Proceedings of the Korean Society of Radiological Science
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• 1999.10a
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• pp.78.3-78.3
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• 1999

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.126-134
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• 2020

Background Pectus excavatum is less common in females than in males, and it often aggravates a coexistent breast asymmetry. We conducted a study comparing female patients' versus medical professionals' evaluation of pectus excavatum repair to assess differences in aesthetic outcome ratings. Moreover, we evaluated the influence of surgical correction on patients' self-perception. Methods Of 30 female patients who were initially screened, 18 patients (mean age, 20 years) who underwent bar removal after surgical correction of pectus excavatum deformity participated in the survey (60%). They completed a questionnaire rating their appearance before and after surgery and responded to a psychological questionnaire about the changes that they had experienced. The mean interval between pectus bar removal and evaluation was 28 months. Standardized preoperative and postoperative patient photographs were evaluated using the same questionnaire by a panel of medical professionals and students (n=24) and the results were compared. Results Patients rated their preoperative deformity as more severe than the other evaluators, revealing the significant impact of the deformity on patients' self-perception. Postoperatively, patient and professional evaluations were much better than before and were very similar. The psychological evaluation showed a clear improvement in well-being. The ratings of the medical professionals were not influenced by their degree of medical education. Conclusions Surgical correction of pectus excavatum in female patients positively influences body perception and psychological well-being. It should therefore not be considered as a merely aesthetic correction, but as an important procedure to restore a patient's self-perception.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.231-235
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• 1997

Congenital cystic adenomatoid malformation of the lung is a rare pulmonary malformation, Although it is one of the most common congenital anomalies which cause acute respiratory distress in the newborn infants, characterized by marked proliferation of terminal respiratory structures. We have experienced an unusual case of congenital cystic adenomatoid malformation associated with pectus excavatum. The patient was 3-year-old female who suffered from cough and high fever for 20 days, and antibiotic therapy was given in other hospital before transfer to our hospital. The findings on chest X-ray, chest CT, aortogram, and selective bronchial arteriogram showed cystic lesions in the right upper and middle lobe accompanied but severe pectus excavatum. Right bilobectomy for pulmonary lesion and costosternal elevation for pectus excavatum was performed simultaneously with successful result. The postoperative course was uneventful and the patient was discharged on the twentieth postoperative day.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.523-526
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• 2008

Minimally Invasive repair of pectus excavatum using a metal bar, as advocated by Nuss, has been broadly accepted recently for its aesthetic aspect. There are and various treatment methods, as welt. Pectus excavatum may be accompaniedso many modified repair methods have been developed and performed. We report a case of a 33-year-old woman with pectus excavatum and breast hypoplasia, which were simultaneously corrected using a substernal steel bar and mammoplasty.