Hakan CEBECİ, Mustafa Yasir ÖZLÜ, Abidin KILINÇER, Mehmet ÖZTÜRK, Hüseyin YILDIRAN, Murat ÖNCEL, Güven Sadi SUNAM

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Pektus Ekskavatum Hastalarında Minimal İnvaziv Cerrahinin Akciğer Hacimlerine Etkisinin Kantitatif BT Volumetri İle Değerlendirilmesi

Amaç: Pektus ekskavatum çocuklarda en sık görülen doğumsal göğüs duvarı anomalisidir. Bu çalışmada minimal invaziv cerrahi yapılan pektus ekskavatum hastalarında akciğer hacimlerinin kantitatif BT volumetri ile araştırılması amaçlanmıştır.Gereç ve Yöntem: Etik kurul onayı alındıktan sonra, Ocak 2012 ile Şubat 2018 tarihleri arasında minimal invaziv pektus ekskavatum cerrahisi yapılmış hastalar retrospektif olarak tarandı. Preoperatif ve postoperatif BT incelemesi bulunan hastalar çalışmaya dahil edildi. BT görüntüleri iş istasyonuna aktarılarak akciğer hacimleri ve Haller indeksleri hesaplandı. Bulgular: Çalışmaya dahil edilen hastaların 11 erkek, 1 kadın ortalama yaşları 16,3 ± 3,7 bulundu. Postoperatif akciğer hacimlerinde anlamlı düzeyde artış saptandı. Total akciğer hacimlerindeki ortalama artış 695 ± 691 ml idi. Preoperatif Haller indeksi ortalaması 3,1’den 2,7’ye düştü ve arada anlamlı fark vardı p=0,002 . Sonuç: Kantitatif BT volumetri, minimal invaziv cerrahi yapılan pektus ekskavatum hastalarında akciğer hacmindeki değişiklikleri değerlendirilmesinde yararlı bilgiler sağlamaktadır
Anahtar Kelimeler:

Bilgisayarlı tomografi, kantitatif volumetri, pektus ekskavatum, haller indeksi

Evaluation of the effect of minimally invasive surgery on lung volumes with quantitative CT volumetry in pectus excavatum patients

Objective: Pectus excavatum is the most common congenital chest wall anomaly in children. In this study, we aimed to investigate lung volumes of patients with pectus excavatum who underwent minimally invasive surgery by quantitative CT volumetry.Material and Methods: After the institutional review board approval, pectus excavatum patients who underwent minimal invasive surgery between January 2012 and February 2018 were searched retrospectively. Patients with preoperative and postoperative CT examinations were included in the study. CT images were transferred to the workstation and lung volumes and Haller’s indices were calculated.Results: The mean ages of the patients 11 male, 1 female included in the study were 16.3 ± 3.7. There was a significant increase in postoperative lung volumes. The mean increase in total lung volumes was 695 ± 691 ml. Preoperative mean Haller’s index decreased to 2.7 from 3.1 with significant difference p = 0.002 .Conclusion: Quantitative CT volumetry gives valuable data for evaluating lung volume changes in pectus excavatum patients that were applied minimally invasive surgery
Keywords:

Computed tomography, quantitative volumetry, pectus excavatum, haller’s index,

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  • Mak SM, Bhaludin BN, Naaseri S, Di Chiara F, Jordan S, Padley S. Imaging of congenital chest wall deformities. The British journal of radiology. 2016;89(1061):20150595.
  • Jeong JY, Ahn JH, Kim SY, Chun YH, Han K, Sim SB, et al. Pulmonary function before and after the Nuss procedu- re in adolescents with pectus excavatum: correlation with morphological subtypes. Journal of cardiothoracic surgery. 2015;10(1):37.
  • Kuru P, Dudakli A, Mursaloglu H, Arikan H, Oktay A, Yuksel M. How pulmonary function changes after pectus excavatum correction surgery. Asian Cardiovascular and Thoracic Annals. 2015;23(8):945-9.
  • Kelly RE, Mellins RB, Shamberger RC, Mitchell KK, Lawson ML, Oldham KT, et al. Multicenter study of pectus excava- tum, final report: complications, static/exercise pulmonary function, and anatomic outcomes. Journal of the American College of Surgeons. 2013;217(6):1080-9.
  • Kim KH, Lee KY, Lee JB, Yang K-S, Hwang J, Je BK, et al. Radiologic factors related to double-bar insertion in mini- mal invasive repair of pectus excavatum. World Journal of Pediatrics. 2015;11(2):148-53.
  • Daunt SW, Cohen JH, Miller SF. Age-related normal ran- ges for the Haller index in children. Pediatric radiology. 2004;34(4):326-30.
  • aller JA, Kramer SS, Lietman SA. Use of CT scans in selec- tion of patients for pectusexcavatum surgery: a preliminary report. Journal of pediatric surgery. 1987;22(10):904-6.
  • Binazzi B, Bruni GI, Gigliotti F, Coli C, Romagnoli I, Mes- sineo A, et al. Effects of the Nuss procedure on chest wall kinematics in adolescents with pectus excavatum. Respira- tory physiology & neurobiology. 2012;183(2):122-7.
  • Sujka JA, Peter SDS, editors. Quantification of pectus ex- cavatum: anatomic indices. Seminars in pediatric surgery; 2018: Elsevier.
  • Pilegaard HK. Short Nuss bar procedure. Annals of cardio- thoracic surgery. 2016;5(5):513.
  • Aronson DC, Bosgraaf RP, Merz E-M, van Steenwijk RP, van Aalderen WM, van Baren R. Lung function after the minimal invasive pectus excavatum repair (Nuss procedu- re). World journal of surgery. 2007;31(7):1518-22.
  • Nuss D, Kelly RE, Croitoru DP, Katz ME. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. Journal of pediatric surgery. 1998;33(4):545-52.
  • Pilegaard HK, Licht PB. Early results following the Nuss operation for pectus excavatum–a single-institution expe- rience of 383 patients. Interactive Cardiovascular and tho- racic surgery. 2008;7(1):54-7.
  • Uemura S, Nakagawa Y, Yoshida A, Choda Y. Experience in 100 cases with the Nuss procedure using a technique for stabilization of the pectus bar. Pediatric surgery internatio- nal. 2003;19(3):186-9.
  • Zeng Q, Lai J-Y, Wang C-J, Cheng H-Y, Chu C-C, Chang C-J, et al. A cross-sectional study of lung volume develop- ment in pectus excavatum patients: estimating the total lung volume from chest computed tomograph using 3-di- mensional volumetric reconstruction. Journal of pediatric surgery. 2010;45(12):2322-7.
  • Sengul AT, Sahin B, Celenk C, Basoglu A, Sengul B. The effect of minimally invasive surgical repair on the lung vo- lumes of patients with pectus excavatum. The Thoracic and cardiovascular surgeon. 2014;62(03):226-30.
  • Rha EY, Kim JH, Yoo G, Ahn S, Lee J, Jeong JY. Changes in thoracic cavity dimensions of pectus excavatum patients following Nuss procedure. Journal of thoracic disease. 2018;10(7):4255.
  • Shamberger RC. Cardiopulmonary effects of anterior chest wall deformities. Chest surgery clinics of North America. 2000;10(2):245-52, v-vi.
  • Lawson ML, Mellins RB, Tabangin M, Kelly Jr RE, Croito- ru DP, Goretsky MJ, et al. Impact of pectus excavatum on pulmonary function before and after repair with the Nuss procedure. Journal of pediatric surgery. 2005;40(1):174-80.
  • Zhao L, Feinberg MS, Gaides M, Ben-Dov I. Why is exerci- se capacity reduced in subjects with pectus excavatum? The Journal of pediatrics. 2000;136(2):163-7.
  • Sigalet DL, Montgomery M, Harder J. Cardiopulmonary effects of closed repair of pectus excavatum. Journal of pe- diatric surgery. 2003;38(3):380-5.
Genel Tıp Dergisi-Cover
  • ISSN: 2602-3741
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1997
  • Yayıncı: SELÇUK ÜNİVERSİTESİ > TIP FAKÜLTESİ
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