Sedat GÜRKÖK, Kunter BALKANLI, Mehmet DAKAK, Onur GENÇ, Alper GÖZÜBÜYÜK

Pektus ekskavatum ve karinatum deformitesinin cerrahi düzeltilmesi: 223 olguluk 5 yıllık tecrübe

Amaç: Kliniğimizde cerrahi tedavi ile düzeltilen pektus ekskavatum ve karinatum deformiteli olguların 5 yıllık sonuçlarını irdelemek. Materyal ve Metod: Ekim 1997 - Mayıs 2002 yılları arasında 223 olguya pektus deformite düzeltilmesi ameliyatı uygulandı. Seksendokuz olguya modifiye Ravitch tekniği, 53 olguya otolog kartilaj implantasyon tekniği, 81 olguya rezorbe olabilen plak tekniği kullanıldı. Bulgular: Ortalama hastanede kalış süresi 16.6 ± 3 gün olarak tespit edildi. Hiçbir olguda majör komplikasyon gözlenmedi. Toraks stabilitesi tüm olgularda ortalama 27.08 ± 5 gün olarak tespit edildi. Postoperatif erken komplikasyon olarak toplam 13 olguda seroma, 5 olguda cilt insizyonu enfeksiyonu ve 11 olguda pnömotoraks tespit edildi. Geç postoperatif komplikasyon olarak 3 hafif derecede, 1 orta derecede rekürrens gözlendi. Sonuç: Pektus ekskavatum ve karinatum deformitesi psikolojik ve kozmetik nedenlerden dolayı başarılı bir şekilde cerrahi ile düzeltilebilir. Sternum fiksasyonu için kullanılan metal destekleri çıkarmak, ikinci bir ameliyat gerektirmektedir. Ayrıca kullanılan bu metal desteklerin yerinden oynaması ile ciddi komplikasyonlar oluşabilmektedir. Rezorbe olabilen plak kullanılan olgularda vücutta yabancı bir cisim olmaması, ikinci bir operasyonu gerektirmemesi ve oluşabilecek ciddi komplikasyonlara neden olmamasından dolayı birçok avantajlara sahiptir.

Surgical correlation of pectus excavatum and carinatum deformities: 5-year of experience with 223 patients

Background: To review the surgical experience with pectus excavatum and carinatum chest deformities at the last 5-years. Methods: Hospital records from 223 patients who underwent repair for pectus deformities between October 1997 and May 2002 were reviewed. Repair was performed with modified Ravitch's technique in 89 cases, implantation of grafts using costal cartilage technique in 53 cases and resorbable plaque technique in 81 cases. Results: The mean hospital stay was 16.6 ± 3 days. There were no major complications. Early postoperative complications included seroma in 13 patients, infection on skin incision in five, and pneumothorax in 11 patients. Late postoperative complications included three well tolereted, and one moderate in tolerated recurrence. Conclusion: Pectus excavatum and carinatum deformities can be repaired with a low rate of complications, a short hospital stay, and excellent long-term physiologic and cosmetic results. It has some advantages to use rezorbe olabilen plaque technique such as avoiding a second operation for removal of the metal support and possible severe complications due to the migration of the metal support.

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