• Journal of Chest Surgery
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• 제15권3호
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• pp.303-307
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• 1982

Two patients with funnel chest deformity were corrected in the department of Thoracic Surgery, N.M.C. The first case was a 12 months old male suffering from recurrent upper respiratory tract infection and symmetrical funnel chest deformity, of which hollow cavity was measured 40 ml of water. He was corrected by method of sternal turnover. The result was satisfactory. The second case was a 16 years old male suffering from exertional dyspnea, recurrent upper respiratory tract infection, wheezing sound [esp., at night], and asymmetrical funnel chest deformity, of which hollow cavity was measured 80 ml of water. He was corrected by modified Ravitch method. Until postoperative 4 months, result was satisfactory. Thereafter, respiratory wheezing, exertional dyspnea and chest wall deformity were returned to pre-operative status.

• Journal of Chest Surgery
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• 제15권1호
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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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• 제10권1호
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• pp.1-6
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• 1977

Two patients with funnel chest deformity corrected in the Department of Thoracic Surgery, Korea University Hospital are presented. The first case was a 21 year old male suffering from exertional dyspnea and recurrent upper respiratory tract infection with asymmetrical funnel Chest deformity, which the hollow cavity was measured 250ml of water. He was corrected by Ravitch method. The result was uneventful. The second case was a 34 year old male with symmetrical and asymptomatic deformity which the hollow cavity was measured 45ml of water. He was corrected by the method of sternal turnover [Wada Method]. On postoperative 8th day, seroma was noted in subxiphoid space and followed secondary infection of the pseudomonas. So, the infected cartilages were resected and curetted. The result was uneventful.

• Journal of Chest Surgery
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• 제45권6호
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• pp.418-420
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• 2012

Pectus excavatum is rare, but it is the most common type of sternal congenital disorder. There are many surgical methods to correct pectus excavatum such as the Ravitch method, Wada method, Silastic mold method, and the Nuss operation. We report a case of minimal invasive surgery for pectus excavatum using a polyvinyl alcohol sponge.

• Journal of Chest Surgery
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• 제20권1호
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• pp.161-170
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• 1987

Fifty-nine cases of congenital chest wall defects experienced in the department of thoracic surgery of Seoul National University Hospital were analyzed and the relevant literatures were reviewed. They are 52 cases of funnel chest, 3 cases of pigeon breast, one case of superior sternal fissure, one case of costochondral incurvation, one case of Cantrell`s pentalogy, and one case of Poland`s syndrome. Funnel chest affected males more frequently than females by 44 to 8. All of the funnel deformities were corrected by Ravitch operation or its modification except one which was the first case of this series and was corrected by a sterno-turnover. Two cases required a mechanical ventilation for 3 days and 5 days respectively. Four minor complications which were two cases of skin wound infection and 2 cases of fluid accumulation were noted. Skin would infection was repaired by a secondary closure and fluid accumulation was treated by aspiration only. The result are all excellent without recurrence or reoperation. In 3 cases of pigeon breast, they were treated by subperichondrial resection of all of the involved costal cartilages and shortening their course with reefing sutures in the perichondrium with excellent result. The superior sternal fissure which was combined by a ventricular septal defect was treated by a simple wire closure with a good result. The costochondral incurvation was corrected by subperichondrial resection of deformed cartilages and a rib graft removed from the contralateral normal side. The Poland syndrome and the Cantrell`s pentalogy was already presented previously.

• Journal of Chest Surgery
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• 제11권3호
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• pp.246-252
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• 1978

A three year and seven month old girl with moderate depression deformity of the sternum associated with a huge well defined homogenous hazy mass density of the upper half of the right hemithorax on plain chest x-ray had developed, exertionaI dyspnea (Figs1, 2 and 3). Correction of the funnel chest was carried out with modified Ravitch procedure and resection of the intrathoracic cystic mass was performed through an anterolateral thoracotomy incision in one stage operation satisfactorily (Figs. 7 and 8). On exploration, the mass, $15{\times}12{\times}10$cm in size, was connected to the bronchus at 1cm a bove the carina by a stalk (Fig. 4). The outer surface showed abundant vasculature. The specimen was filled with mucoid material; the inner surface was much trabeculated. glistening and smooth (Fig. 5 and 6). yficroscopically, the cyst was lined with simple or pseudostratified ciliated columnar epithelium. The cystic wall was composed of loose fibrous connective tissue, muscle layers, cartilages with some lymphocytic infiltration (Fig. 9). Isolated cases of funnel chest deformity and congenital bronchogenic cystic disease are not uncommon; however, the assocbtion of the two conditions is yery rare. Therefore. report and review of the literature was done.

• Journal of Chest Surgery
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• 제16권1호
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• pp.183-190
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• 1983

Pectus Excavatum is a congenital anomaly of the anterior chest wall with a sharp concave curvature of the body of the sternum, from above downward and from side to side, especially just before the junction of gladiolo-xiphoid. We have experienced 14 cases of Pectus Excavatum with several operative procedures, i.e., Ravitch operation in 1 case, Wada operation [Sternal turn-over} in 3 cases, Wada operation and K-wire splint in 5 cases, Modified Wada operation [Rectus Abdominis muscle pedicle attached sternal turn-over] in 5 cases. Nearly all patients developed flail chest treated with internal fixation, and necrotic chondritis was developed postoperatively and treated with excision and curettage in one case with Wada operation. Follow-up Vertebral Index showed 48% preoperatively and 33% postoperatively, average decrement of 15%. We report 14 cases of Pectus Excavatum and their operative treatments.

• Journal of Chest Surgery
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• 제49권3호
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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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• 제25권12호
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• pp.1416-1421
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• 1992

There are many objective indices of operative outcome of funnel chest, but there has been only a few report about the postoperative change of these indices and which is best correlated with subjective outcome. From January 1989 to December 1991, 74 patients with funnel chest underwent Ravitch operation and radiologic evaluation was performed on the twenty patients whose operative outcome were satisfactory by Humphreys` criteria and postoperative chest X-ray were available. Variable radiologic chest idices such as deformity grade [DG], lower vertebral index [LVI], upper vertebral index [UVI] and configuration index [CI] were measured preoperatively and 1, 6, 12 and 18 months pos-toperatively. The mean value of preoperative DG, LVI, UVI and CI were 5.32, 0.3, 0.26 and 1.01 respectively, and postoperative chages were as follows; DG; 3.13, 3.66, 3, 72, 4.0, LVI: 0.22, 0, 24, 0.25, 0.25 UVI; 0.27, 0.27, 0.27, 0.27 CI; 0.69, 0.77, 0.76, 0.79. The increments of CI were within the 90 percent confidence limit of normogram in most cases, but it was not true for LVI and UVI. And the differences between the observed and expected values of CI did not change significantly through the postoperative periods, which was not the case in LVI. We concluded from these results that 1] DG, LVI and CI were increased slowly during the postoperative follow up periods but the increments of CI were usually within the normal limits and so 2] CI can be used as a objective index of satisfactory outcome.

• Journal of Chest Surgery
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• 제31권3호
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• pp.286-290
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• 1998

누두흉은 하부흉골과 인접늑연골이 함몰되는 선천성 기형으로 흉벽기형중 가장 흔한 질환이다. 대부분 미용적인 이유로 수술이 시행되어지며 수술시기는 신체적 및 정신적인 면을 고려할 때 학동기 이전에 하는것이 바람직한 것으로 되어있다. 최근 Ravitch술식에 의한 흉골거상법과 Wada술식에 의한 흉골반전법이 누두흉의 치료에 좋은 성적을 보이고 있다. 이에 본 교실에서는 누두흉의 외과적 치험례를 후향적으로 조사하여 적절한 수술치료 방향에 도움을 얻고자 본 연구를 시도하게 되었다. 본 연구에서는 1981년 1월부터 1996년 7월까지 누두흉의 외과적치료를 받은 24례의 환자들을 대상으로 성별및 연령별 분포, 주소, 동반질환유무, 변형의 정도, 심전도소견, 술후 합병증, 술후 환자 및 보호자의 만족도등을 분석하였다. 변형의 교정치는 일부에서 웰치지수(welch index)를 이용하여 술전 및 술후 변화를 관찰하였고, 만족도는 Humphreys 평가기준에 따라 분류하였다. 술후 합병증은 창상감염 2례, 기흉 2례, 재발 1례있었으며, 창상감염은 정기적인 dressing으로 치료되었고, 기흉은 폐쇄식 흉관삽관술을 시행하여 치료되었다. 재발 1례는 Ravitch술식후 발생하였으며 이는 다시 변형 Wada술식으로 교정하였다. 웰치지수(welch index)는 술전 평균 5.86이었으며 술후 4.10으로 의미있게 감소하였다(P<0.05). 환자의 만족도는 Humphreys 평가기준상 excellent 17례, good 4례로 만족스런 결과를 얻었다.