Apport de la conception assistée par ordinateur (CAO) à la réalisation des implants thoraciques sur mesure pour correction des pectus excavatum. Expérience du CHU de Nantes

H. Tilliet Le Dentu; U. Lancien; O. Sellal; F. Duteille; P. Perrot

doi:10.1016/j.anplas.2017.11.006

Apport de la conception assistée par ordinateur (CAO) à la réalisation des implants thoraciques sur mesure pour correction des pectus excavatum. Expérience du CHU de Nantes

Annales de Chirurgie Plastique Esthétique ◽

10.1016/j.anplas.2017.11.006 ◽

2018 ◽

Vol 63 (1) ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

H. Tilliet Le Dentu ◽

U. Lancien ◽

O. Sellal ◽

F. Duteille ◽

P. Perrot

Keyword(s):

Pectus Excavatum ◽

Conception Assistée

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Minimally Invasive Repair of Pectus Excavatum (MIRPE) - The Basel Experience

Swiss Surgery ◽

10.1024/1023-9332.9.6.289 ◽

2003 ◽

Vol 9 (6) ◽

pp. 289-295 ◽

Cited By ~ 19

Author(s):

Haecker ◽

Bielek ◽

von Schweinitz

Keyword(s):

Minimally Invasive ◽

Pectus Excavatum ◽

Pulmonary Function Tests ◽

Preoperative Evaluation ◽

Skin Incision ◽

Original Method ◽

Restrictive Lung Disease ◽

Cardiac Compression ◽

Cardiac Evaluation ◽

Indications For Operation

Purpose: Minimally invasive repair of pectus excavatum (MIRPE) was first reported in 1998 by D. Nuss. This technique has gained wide acceptance during the last 4-5 years. In the meantime, some modifications of the technique have been introduced by different authors. Our retrospective study reports our own experience over the last 36 months and modifications introduced due to a number of complications. Methods: From 3/2000 to 3/2003, 22 patients underwent MIRPE. Patients median age was 15.5 years (10.7 to 20.3 years). Standardised preoperative evaluation included 3D computerised tomography (CT) scan, pulmonary function tests, cardiac evaluation with electrocardiogram and echocardiography, and photo documentation. Indications for operation included at least two of the following: Haller CT index > 3.2, restrictive lung disease, cardiac compression, progression of the deformity and severe psychological alterations. Results: In 22 patients (2 girls, 20 boys) undergoing MIRPE procedure, a single bar was used in 21 patients and two bars in one boy. Lateral stabilisers were fixed with non resorbable sutures on both sides. Overall, postoperative complications occurred in six patients (27.3%). In two patients (9.1%) a redo-procedure was necessary due to bar displacement. An additional median skin incision was performed in two patients to elevate the sternum. Pneumothorax or hematothorax in two patients resulted in routine use of a chest tube on both sides. Long-term favourable results were noted in all patients. Conclusions: The MIRPE procedure is an effective method with elegant cosmetic results. Modifications of the original method help to decrease the complication rate and to accelerate acquirement of expertise.

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