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Pectus Excavatum / Pectus Carinatum: surgical treatment

BACKGROUND: The authors present the results obtained with one technique for Pectus Carinatum and Pectus Excavatum treatment. METHODS: From 1976 to 2000, 183 patients with chest wall deformities underwent surgery at the Hospital Universitario Cajuru of the Catholic University of Parana. Nighty eight were pectus carinatum (70 symmetric pectus carinatum, 18 lateral pectus carinatum to the right and 10 lateral pectus excavatum to the left), 62 were pectus excavatum (57 symmetric pectus excavatum, four lateral pectus excavatum to the right and one lateral pectus excavatum to the left), 17 were pouter pigeon, one was pectus carinatum with pectus excavatum, four were inferior costal protusions and one costal depression. The indication was exclusively aesthetical in 182 (99,4%) of the patients. For both pectus carinatum and pectus excavatum only one technique was used: inframammary transversal incision, subperichondral ressection of all cartilages involved in the deformity, minimal retrosternal dissection, anterior sternal osteotomy, fastening of the sternal osteotomy with a steel wire. A retrosternal plate can be used in selected Pectus Excavatum cases, folding of the perichondrial bundles to give more rigidity to the thoracic wall and to help keep the sternum in its position, drainage of the subcutaneous cellular tissue and of the submuscular space, intradermal suture of the skin. RESULTS: A good and / or excellent aesthetic result was obtained in 175 (95,6%) of the patients. Complication occurred in 14 (7,6%) patients: eight (4,5%) seroma cases, one (0,5%) hematoma of the chest wall, two( 91,0%) cases of severe chest pain in the post-operative period; one (0,5%) case of dehiscence of skin suture and two cases (1,0%) of hyperthrophic scar, which were treated with ressection and betatherapy. CONCLUSION: The aesthetic results obtained allow us indicate the sternochondroplasty for treatment of Pectus Carinatum and Pectus Excavatum.

Funnel chest; Abdormalities; Surgical procedures, operative


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