Ali KUTLU, Turgut IŞITMANGİL, Kunter BALKANLI, Rauf GÖRÜR, Akın YILDIZHAN

Comparison of retrosternalmetal supportand absorbable plaque in correction of pectus deformities

Amaç: Doğumsal anterior göğüs duvarı deformitelerinin en sık görülenleri pektus ekskavatum ve pektus karinatumdur. Bu yazıda pektus deformitelerini düzeltme operasyonlarında sternal tespit amacıyla sternum arkasına metal destek uygulaması ve emilebilir plak kullanımının karşılaştırılmasını yapmayı amaçladık. Gereç ve Yöntem: Otuz sekiz hastada cerrahi düzeltme klasik Rawitch tekniği kullanılarak yapıldı. Bu hastaların 29'unda pektus ekskavatum ve 9'unda da pektus karinatum deformitesi mevcuttu. Sternum tespiti amacıyla 26 hastada sternum arkasına metalik destek ve 12 hastada ise Balkanlı Tekniği kullanılarak emilebilen ko-polimer plak ve vida (LaktoSorb) kullanıldı.Bulgular: Mortalite veya morbidite gözlenmedi. Sternum arkasındaki bar 3-6 ay sonra çıkarıldı. Hastalar 24-37 ay izlendi ve hafif dereceli bir nüks dışında hiçbir komplikasyon gözlenmedi.Sonuç: Pektus deformitelerinin cerrahi düzeltilmesinde her iki teknik de güvenli bir şekilde uygulanabilir. Sternum arkasına bar konulması daha ucuz bir tekniktir, fakat literatürde belirtilen komplikasyonlar açısından daha yakın izlemi ve ikinci bir operasyonu gerektirir. Emilebilen plak aynı etkiye sahiptir. Bunun yanında daha güvenli olmasına rağmen sternum arkasına bar uygulaması ile kıyaslandığında daha pahalı bir yöntemdir.

Pektus deformitelerinin düzeltilmesinde retrosternal metal destek ile absorbabl plak karşılaştırması

Objective: The most common types of congenital anterior chest wall deformities are pectus excavatum and pectus carinatum. In this paper, we tried to compare correction operations of pectus deformities by using retrosternal metal support and absorbable plaque for sternal fixation. Materials and Methods: Surgical correction was performed in 38 patients by applying classical Ravitch technique. Twenty nine of these patients had pectus excavatum and 9 of them had pectus carinatum deformity. All patients were male and the mean age was 23.3 (21-28). For sternal fixation, retrosternal metallic support was used in 26 patients and the resorbable copolymer plaque and polymer screw (The Lactosorb“ material) for 12 patients were used with Balkanlı technique.Results: There was no mortality and morbidity. Retrosternal bar was removed after 3-6 months. Patients were followed up for 24-37 months and no complication was observed except a minimal relapse.Conclusion: Both of the two techniques can be applied with confidence in the surgical correction of pectus deformities. Retrosternal bar usage is a cheaper technique, however needs closer follow-up for its published complications in the literature and requires sometimes a second operation. Absorbable plaque has the same efficacy. Although more reliable, it is more expensive when compared with the retrosternal bar usage.

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