P162. A Novel and Safe Surgical Technique for Pectus Excavatum Correction
Advanced Cardiothoracic Consultants, LLC
London
United Kingdom - Contact Me
Prof. Shyam Kolvekar is one of the leading cardiothoracic surgeons in London, currently working at Barts Heart Centre (St Bartholomew’s Hospital). He is a Honorary Associate Professor at University College London, and involved in several research projects. He is also Honorary Professor at University of Manipal and at Apollo Hospital Educational & Research Foundation.. He has a special interest in mitral valve repairs, beating-heart surgery, cardiac arrhythmias and minimally-invasive cardiac surgery and is concerned with ischaemic pre-conditioning of the heart. He also has a thoracic practice dealing with lung cancer, pneumothorax, pleural effusion and chest wall deformities. He is leading the national pectus MDT (MultiDicipolinary Team Meeting) in England and he has help to start first national pectus centre in England at St Bartholomew’s Hospital. This is a world class service for chest wall deformity.
Description
Pectus excavatum is a congenital chest wall deformity characterized by a sunken sternum, which can result in both cosmetic and physiological concerns. While traditional surgical techniques, such as the Nuss and Ravitch procedures, are commonly used, they are associated with significant morbidity, extended recovery times, and potential complications. This study presents a "Pectus Up" , novel and safe operation technique aimed at reducing these risks while maintaining or improving the correction of the deformity.
Methods:
Between 15-38 years of age patients with pectus excavatum underwent the novel procedure at UK, Ireland, India and Australia. The operation is as follows: the Pectus Up implant is placed on top of the sternum, at the subpectoral level, in the most sunken area of the chest. Subsequently, by means of an elevation system, the sternum is lifted to the desired position and is fixed with the implant.. Intraoperative and postoperative outcomes, including operative time, blood loss, length of hospital stay, and complication rates, were recorded and compared with historical controls who underwent traditional procedures.
Results:
The novel procedure took average of 45 minutes compared to 90-120 minutes for NUSS procedure and around 180minute for Ravitch Procedure, with small incision in front of chest. There is minimal blood loss. There is no necessity of thoracoscope. The average hospital stay was reduced to 2 days compared to 5 -7days for NUSS or Ravitch Procedure. No major complications, such as infection or bar displacement, pneumothorax, haemothorax , were observed in this cohort. Patient satisfaction scores were high reporting significant improvement in both the cosmetic and physiological aspects of the condition. The pain management with much easier without cryoablation or epidural. Patients with pectus up needed oral analgesics for average of 2 weeks ,compared to 4-6 weeks of oral analgesics treatment for NUSS and Ravitch procedure.
Conclusion:
This study demonstrates that the novel surgical technique for pectus excavatum is not only safe but also offers advantages over traditional methods, including reduced morbidity and improved patient outcomes. Further studies with a larger cohort and longer follow-up are recommended to confirm these findings.
Authors
shyam Kolvekar (1), Karen REdmond (2)
Institutions
(1) Advanced Cardiothoracic Consultants, LLC, London, United Kingdom, (2) The Mater Hospital, Dublin, NA