Absorbable stabilisation of the bar in minimally invasive repair of pectus excavatum

Michele Torre, V. Jasonni, C. Asquasciati, S. Costanzo, M. V. Romanini, P. Varela

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Introduction: The minimally invasive repair of pectus excavatum has become the preferred technique in most centres. One of the most important technical points for the final result is stabilisation of the bar, usually obtained by one or two metal stabilisers. Recently, long-term absorbable stabilisers have become available (LactoSorb®, Biomet, Jacksonville, FL, USA). Made of poly-L-lactic and polyglycolic acid, they have been introduced with the aim of reducing local discomfort and making removal of the bar easier. Their efficacy for the stabilisation of the bar has not been proved yet. In this paper we compare the surgical outcome in two groups of patients, one treated with metallic and the other with absorbable stabilisers. Material and Methods: A total of 280 patients underwent pectus excavatum repair using a Nuss technique in two centres. In 194 patients (group 1), operated on since 2001, the metallic stabiliser was used. In 86 patients (group 2), operated on since February 2007, the LactoSorb® stabiliser was preferred. We compared both groups in terms of surgical details, local symptoms or complications, and bar instability rate. Results: The surgical technique for the stabilisation of the bar was identical in both groups, but in group 1 the stabiliser was fastened to the bar with a steel wire, while in group 2 polyglycolic sutures were used. No differences in local discomfort or postoperative pain were observed between the groups. The LactoSorb® stabiliser was palpable for at least 6-9 months, and progressively disappeared at 9-12 months. In group 1 we observed 6 local complications. In particular, two patients presented with infection, one of them associated with a skin lesion and opening over the metallic stabiliser (revision of the wound was performed). Another patient developed a thoracic wall haematoma after suffering a trauma over the metallic stabiliser, 13 months after operation. Three patients developed a seroma. In group 2 we observed 3 subcutaneous swellings at the site of the LactoSorb® stabiliser at 6, 8 and 9 months after the operation. We did not observe either skin lesions or infections. In the group with metallic stabiliser, 3 patients (1.5 %) had bar dislocation, while we did not observe bar instability in the group with LactoSorb® stabiliser. Conclusions: LactoSorb® stabiliser is safe and effective for stabilising the bar in pectus surgery. We suggest its routine use as it appears to be less traumatic and could make bar removal easier.

Original languageEnglish
Pages (from-to)407-409
Number of pages3
JournalEuropean Journal of Pediatric Surgery
Volume18
Issue number6
DOIs
Publication statusPublished - Dec 2008

Fingerprint

Funnel Chest
Seroma
Skin
Steel
Cimetidine
Wounds and Injuries
Thoracic Wall
Postoperative Pain
Infection
polylactic acid-polyglycolic acid copolymer
Hematoma
Sutures
Metals

Keywords

  • Minimally invasive repair of pectus excavatum
  • Pectus excavatum
  • Thoracic malformations

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Absorbable stabilisation of the bar in minimally invasive repair of pectus excavatum. / Torre, Michele; Jasonni, V.; Asquasciati, C.; Costanzo, S.; Romanini, M. V.; Varela, P.

In: European Journal of Pediatric Surgery, Vol. 18, No. 6, 12.2008, p. 407-409.

Research output: Contribution to journalArticle

Torre, Michele ; Jasonni, V. ; Asquasciati, C. ; Costanzo, S. ; Romanini, M. V. ; Varela, P. / Absorbable stabilisation of the bar in minimally invasive repair of pectus excavatum. In: European Journal of Pediatric Surgery. 2008 ; Vol. 18, No. 6. pp. 407-409.
@article{f60e01adc699434996b877b4854c1027,
title = "Absorbable stabilisation of the bar in minimally invasive repair of pectus excavatum",
abstract = "Introduction: The minimally invasive repair of pectus excavatum has become the preferred technique in most centres. One of the most important technical points for the final result is stabilisation of the bar, usually obtained by one or two metal stabilisers. Recently, long-term absorbable stabilisers have become available (LactoSorb{\circledR}, Biomet, Jacksonville, FL, USA). Made of poly-L-lactic and polyglycolic acid, they have been introduced with the aim of reducing local discomfort and making removal of the bar easier. Their efficacy for the stabilisation of the bar has not been proved yet. In this paper we compare the surgical outcome in two groups of patients, one treated with metallic and the other with absorbable stabilisers. Material and Methods: A total of 280 patients underwent pectus excavatum repair using a Nuss technique in two centres. In 194 patients (group 1), operated on since 2001, the metallic stabiliser was used. In 86 patients (group 2), operated on since February 2007, the LactoSorb{\circledR} stabiliser was preferred. We compared both groups in terms of surgical details, local symptoms or complications, and bar instability rate. Results: The surgical technique for the stabilisation of the bar was identical in both groups, but in group 1 the stabiliser was fastened to the bar with a steel wire, while in group 2 polyglycolic sutures were used. No differences in local discomfort or postoperative pain were observed between the groups. The LactoSorb{\circledR} stabiliser was palpable for at least 6-9 months, and progressively disappeared at 9-12 months. In group 1 we observed 6 local complications. In particular, two patients presented with infection, one of them associated with a skin lesion and opening over the metallic stabiliser (revision of the wound was performed). Another patient developed a thoracic wall haematoma after suffering a trauma over the metallic stabiliser, 13 months after operation. Three patients developed a seroma. In group 2 we observed 3 subcutaneous swellings at the site of the LactoSorb{\circledR} stabiliser at 6, 8 and 9 months after the operation. We did not observe either skin lesions or infections. In the group with metallic stabiliser, 3 patients (1.5 {\%}) had bar dislocation, while we did not observe bar instability in the group with LactoSorb{\circledR} stabiliser. Conclusions: LactoSorb{\circledR} stabiliser is safe and effective for stabilising the bar in pectus surgery. We suggest its routine use as it appears to be less traumatic and could make bar removal easier.",
keywords = "Minimally invasive repair of pectus excavatum, Pectus excavatum, Thoracic malformations",
author = "Michele Torre and V. Jasonni and C. Asquasciati and S. Costanzo and Romanini, {M. V.} and P. Varela",
year = "2008",
month = "12",
doi = "10.1055/s-2008-1039176",
language = "English",
volume = "18",
pages = "407--409",
journal = "European Journal of Pediatric Surgery",
issn = "0939-7248",
publisher = "Thieme Medical Publishers",
number = "6",

}

TY - JOUR

T1 - Absorbable stabilisation of the bar in minimally invasive repair of pectus excavatum

AU - Torre, Michele

AU - Jasonni, V.

AU - Asquasciati, C.

AU - Costanzo, S.

AU - Romanini, M. V.

AU - Varela, P.

PY - 2008/12

Y1 - 2008/12

N2 - Introduction: The minimally invasive repair of pectus excavatum has become the preferred technique in most centres. One of the most important technical points for the final result is stabilisation of the bar, usually obtained by one or two metal stabilisers. Recently, long-term absorbable stabilisers have become available (LactoSorb®, Biomet, Jacksonville, FL, USA). Made of poly-L-lactic and polyglycolic acid, they have been introduced with the aim of reducing local discomfort and making removal of the bar easier. Their efficacy for the stabilisation of the bar has not been proved yet. In this paper we compare the surgical outcome in two groups of patients, one treated with metallic and the other with absorbable stabilisers. Material and Methods: A total of 280 patients underwent pectus excavatum repair using a Nuss technique in two centres. In 194 patients (group 1), operated on since 2001, the metallic stabiliser was used. In 86 patients (group 2), operated on since February 2007, the LactoSorb® stabiliser was preferred. We compared both groups in terms of surgical details, local symptoms or complications, and bar instability rate. Results: The surgical technique for the stabilisation of the bar was identical in both groups, but in group 1 the stabiliser was fastened to the bar with a steel wire, while in group 2 polyglycolic sutures were used. No differences in local discomfort or postoperative pain were observed between the groups. The LactoSorb® stabiliser was palpable for at least 6-9 months, and progressively disappeared at 9-12 months. In group 1 we observed 6 local complications. In particular, two patients presented with infection, one of them associated with a skin lesion and opening over the metallic stabiliser (revision of the wound was performed). Another patient developed a thoracic wall haematoma after suffering a trauma over the metallic stabiliser, 13 months after operation. Three patients developed a seroma. In group 2 we observed 3 subcutaneous swellings at the site of the LactoSorb® stabiliser at 6, 8 and 9 months after the operation. We did not observe either skin lesions or infections. In the group with metallic stabiliser, 3 patients (1.5 %) had bar dislocation, while we did not observe bar instability in the group with LactoSorb® stabiliser. Conclusions: LactoSorb® stabiliser is safe and effective for stabilising the bar in pectus surgery. We suggest its routine use as it appears to be less traumatic and could make bar removal easier.

AB - Introduction: The minimally invasive repair of pectus excavatum has become the preferred technique in most centres. One of the most important technical points for the final result is stabilisation of the bar, usually obtained by one or two metal stabilisers. Recently, long-term absorbable stabilisers have become available (LactoSorb®, Biomet, Jacksonville, FL, USA). Made of poly-L-lactic and polyglycolic acid, they have been introduced with the aim of reducing local discomfort and making removal of the bar easier. Their efficacy for the stabilisation of the bar has not been proved yet. In this paper we compare the surgical outcome in two groups of patients, one treated with metallic and the other with absorbable stabilisers. Material and Methods: A total of 280 patients underwent pectus excavatum repair using a Nuss technique in two centres. In 194 patients (group 1), operated on since 2001, the metallic stabiliser was used. In 86 patients (group 2), operated on since February 2007, the LactoSorb® stabiliser was preferred. We compared both groups in terms of surgical details, local symptoms or complications, and bar instability rate. Results: The surgical technique for the stabilisation of the bar was identical in both groups, but in group 1 the stabiliser was fastened to the bar with a steel wire, while in group 2 polyglycolic sutures were used. No differences in local discomfort or postoperative pain were observed between the groups. The LactoSorb® stabiliser was palpable for at least 6-9 months, and progressively disappeared at 9-12 months. In group 1 we observed 6 local complications. In particular, two patients presented with infection, one of them associated with a skin lesion and opening over the metallic stabiliser (revision of the wound was performed). Another patient developed a thoracic wall haematoma after suffering a trauma over the metallic stabiliser, 13 months after operation. Three patients developed a seroma. In group 2 we observed 3 subcutaneous swellings at the site of the LactoSorb® stabiliser at 6, 8 and 9 months after the operation. We did not observe either skin lesions or infections. In the group with metallic stabiliser, 3 patients (1.5 %) had bar dislocation, while we did not observe bar instability in the group with LactoSorb® stabiliser. Conclusions: LactoSorb® stabiliser is safe and effective for stabilising the bar in pectus surgery. We suggest its routine use as it appears to be less traumatic and could make bar removal easier.

KW - Minimally invasive repair of pectus excavatum

KW - Pectus excavatum

KW - Thoracic malformations

UR - http://www.scopus.com/inward/record.url?scp=58149308213&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58149308213&partnerID=8YFLogxK

U2 - 10.1055/s-2008-1039176

DO - 10.1055/s-2008-1039176

M3 - Article

C2 - 19061157

AN - SCOPUS:58149308213

VL - 18

SP - 407

EP - 409

JO - European Journal of Pediatric Surgery

JF - European Journal of Pediatric Surgery

SN - 0939-7248

IS - 6

ER -