Thoracoscopic cartilage resection with partial perichondrium preservation in unilateral pectus carinatum: Preliminary results

Patricio Varela, Michele Torre

Research output: Contribution to journalArticle

Abstract

Background/Purpose: Although minimally invasive repair of pectus excavatum has gained worldwide acceptance, treatment of pectus carinatum is mostly performed with open procedures. Different minimally invasive alternatives have been proposed in the last few years, including subpectoral CO2 dissection and intrathoracic compression (Abramson technique), or conservative procedures, as dynamic compression system. Recently, another surgical technique has been proposed for the treatment of unilateral pectus carinatum, consisting of a thoracoscopic approach and multiple cartilage incisions. The aim of this work is to present our modification to this approach. Methods: We have modified this technique by introducing complete cartilage resection of all anomalous costal cartilages, performed thoracoscopically. Three thoracoscopic ports were used. Cartilage is removed progressively using a rongeur and preserving the anterior perichondrium. Results: We have performed this technique in 4 patients during the last year. Follow-up ranged from 6 to 14 months. No intraoperative or postoperative complications were observed. The results, assessed by the patients themselves, were good in 2 cases, quite good in one, and fair in the first patient of our series, who was reoperated using a classical open approach. Pain was well controlled without the need of an epidural catheter. Conclusion: Thoracoscopic cartilage resection with perichondrium preservation can be considered as feasible alternative for the treatment of unilateral pectus carinatum.

Original languageEnglish
Pages (from-to)263-266
Number of pages4
JournalJournal of Pediatric Surgery
Volume46
Issue number1
DOIs
Publication statusPublished - Jan 2011

Keywords

  • Cartilage rib resection
  • Chest wall anomaly
  • Pectus carinatum
  • Thoracic malformation
  • Thoracoscopy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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