Mehmet SIRMALI, Erkmen GÜLHAN, Hasan TÜRÜT, İrfan TAŞTEPE, Güven ÇETİN, Sadi KAYA, Suat GEZER

Pektus deformiteleri: 51 hastanın klinik ve cerrahi analizi

Amaç: Pektus deformitesi nedeniyle cerrahi düzeltme uygulanan hastaların klinik özellikleri ve cerrahi sonuçları değerlendirildi. Çalışma planı: Pektus ekskavatum (PE) ve pektus karinatum (PK) tanılarıyla cerrahi düzeltme uygulanan 51 hasta (36 erkek, 15 kadın; ort yaş 13; dağılım; 4-27) geriye dönük olarak değerlendirildi. Hastalar yaş, cinsiyet, hastaneye başvuru nedenleri, fizik muayene bulguları, eşlik eden anomaliler, uygulanan cerrahi işlemler, ameliyat sonrası komplikasyonlar ve nüks yönünden incelendi. Olguların ortalama izlem süresi 33.9 ay (dağılım 2-70 ay) idi.Bulgular: Elli bir hastanın 36’sında PE, 15’inde PK vardı. En sık başvuru nedeni estetik yakınmalardı (%39.7). Cerrahi işlem olarak en sık modifiye Ravitch tekniği kullanıldı. Sternal stabilizasyon için üç hastada Prolen yama, bir hastada Kirschner teli kullanıldı. Dokuz olguda (%17.6) ameliyat sonrası komplikasyon gelişti. Bunlar üç olguda pnömotorkas, iki olguda yara yeri enfeksiyonu, iki olguda hemoraji ve birer olguda plevral koleksiyon ve ciltaltı amfizemi idi. Bir hastada PK nedeniyle ameliyattan bir yıl sonra nüks gelişti.Sonuç: Pektus deformiteli hastalarda cerrahi için en ideal yaş aralığı 7-15’tir. Modifiye Ravitch tekniği pektus deformitelerinin düzeltilmesinde güvenli ve başarılı bir şekilde kullanılabilir. Genç erişkinlerde sternal stabilizasyonun sağlanmasında Prolen yama kullanımı etkili bir yöntem olabilir.

Pectus deformities: A clinical and surgical analysis of 51 patients

Background: We analyzed clinical features and surgical results of patients undergoing surgical correction for pectus deformities. Methods: This retrospective review included 51 patients (36 males, 15 females; mean age 13 years; range 4 to 27 years) who underwent surgical repair for pectus excavatum (PE) or pectus carinatum (PC). The patients were evaluated with regard to age, gender, presenting symptoms, physical examination findings, associated anomalies, surgical procedures, postoperative complications, and recurrence. The mean follow- up period was 33.9 months (range 2 to 70 months).Results: Of 51 patients, 36 had PE and 15 had PC. The most common complaint was cosmetic problems (39.7%). The most commonly performed surgical procedure was the modified Ravitch technique. For sternal stabilization, Prolene mesh was used in three patients and a Kirschner wire in one patient. Postoperative complications were encountered in nine patients (17.6%), including pneumothorax (n=3), wound site infection (n=2), hemorrhage (n=2), pleural fluid collection (n=1), and subcutaneous emphysema (n=1). One patient developed recurrence one year after surgery for PC.Conclusion: The optimal age range for corrective surgery for pectus deformities is 7 to 15 years. The modified Ravitch procedure can be used safely and successfully in the repair of such deformities. Prolene mesh may be effective for sternal stabilization in young adults.

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