Surgical treatment of anterior chest wall deformities:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Chest surgery clinics of North America
10,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 227 - 439 Ill. |
Internformat
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| 245 | 1 | 0 | |a Surgical treatment of anterior chest wall deformities |c Francis Robicsek, guest ed. |
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Datensatz im Suchindex
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| adam_text | SURGICAL TREATMENT OF ANTERIOR CHEST
WALL DEFORMITIES
CONTENTS
Preface xj
Francis Robicsek
History of the Operative Management of Pectus
Deformities 227
J. Alex Haller, Jr
This article examines the history of the operative management of
pectus deformities, tracing the surgical innovations of such pio¬
neers as Drs. Ochsner, Ravitch, Sanger, and Wada. Guidelines for
the selection of patients for operative correction are also dis¬
cussed.
Embryology of the Sternum 237
T.W. Sadler
Development of the sternum during the growth of the embryo is
described. Anterior body wall defects in the thoracic region may
be severe, leading to ectopia cordis, or mild, as in skin covered
sternal clefts. The embryologic basis for other sternal abnormali¬
ties, such as pectus excavarum and pectus carniatum, is not clear;
however, abnormalities of rib morphogenesis and growth are the
most likely causes.
Cardiopulmonary Effects of Anterior Chest Wall
Deformities 245
Robert C. Shamberger
Many studies have been conducted that evaluate the cardiopul¬
monary effects of pectus excavatum because of the general clinical
CHEST SURGERY CLINICS OF NORTH AMERICA
VOLUME 10 • NUMBER 2 • MAY 2000 V
impression that post repair patients have better exercise tolerance
and vigor. The results of these studies have been variable during
the last three decades, and although restrictive lung volumes are
often present in subjects with pectus excavatum, they are not
invariably improved by repair. Enhanced cardiac performance
may be partially responsible for improved function. This article
reviews the results of these studies.
Repair of Pectus Excavatum: Anesthetic Considerations 253
Steven A. Robicsek and Emilio B. Lobato
The authors discuss the special anesthetic considerations for pa¬
tients undergoing pectus excavatum repair. Co existing condi¬
tions such as pulmonary disease, spinal abnormalities, cardiac
lesions, and arrhythmias are frequently seen. Perioperative pain
management using an epidural catheter or intercostal blocks as
opposed to parenteral analgesia needs to be addressed. A high
index of suspicion for tension pneumothorax and pneumonia
should be maintained in the postoperative course.
Cleft Sternum and Sternal Foramen 261
Alexander A. Fokin
Cleft sternum is a rare congenital defect of the anterior chest wall
and results from failed midline fusion of the sternum that leaves
the heart and great vessels unprotected. Prenatal diagnosis by
ulrrasonography is possible. Surgical correction should be per¬
formed during the neonatal period when the direct suturing of
the sternal halves is possible and the thorax can accommodate
thoracic viscera. The sternal foramen is a congenital oval defect
at the lower third of the sternum that is asymptomatic and detect¬
able by CT scanning. The awareness of the anomaly is important
in acupuncture practice because of the danger of heart damage.
Surgical Treatment of Pectus Excavatum 277
Francis Robicsek
Pectus excavatum is an anomaly in which the overgrowth of the
costal cartilages causes posterior displacement of the sternum. Its
correction is preferably done by bilateral resection of the de¬
formed cartilages, positional correction of the sternum by trans¬
verse osteotomy, and Marlex mesh posterior support. The use of
cosmetic procedures or, in other words, operations that do not
correct the anomaly of the bony chest wall but use various im¬
plants as camouflage, should be restricted to cases of moderate
excavatum anomalies in late teenaged patients and to adults
without cardiorespiratory symptoms.
Vi CONTENTS
Ectopia Cordis 297
Joseph J. Amato, William I. Douglas, Uptal Desai, and
Stephen Burke
Ectopia cordis is a rare congenital defect in which the heart is
placed externally on the surface of the chest. This article describes
the embrylogic events that lead to the various classifications of
the defect and how they possibly explain the process of its un¬
usual occurrence in children. While survival in some cases is
possible, the ultimate repair is difficult and survival is rare. The
most extreme forms of ectopia cordis, especially those with intra
cardiac defects, have a poor prognosis. Several cases of this rare
anomaly with primary repair and staged repair are discussed.
Turnover Procedure 317
Juro Wada and Wolfgang R. Ade
Sternal turnover can be considered an orthotopic bone trans¬
plantation in reverse position. It yields immediate stability of
the chest and good cosmetic results. Procedures using pedicled
plastrons (rectal muscles, internal mammary arteries) have been
reported; a large series of 300 cases, however, shows satisfying
results with free grafts. Technetium 99m isotope studies yielded
visualization of the plastron 1 year after sternal turnover. After
redo operations, histopathologic studies gave nearly normal ster¬
nal bone marrow findings.
Minimally Invasive Pectus Surgery 329
Andre Hebra
The technique of minimally invasive repair of pectus excavatum
is a new operation that allows for repair of this deformity without
any cartilage resection or sternal osteotomy. The procedure has
revolutionized the management of pectus excavatum. The innova¬
tive incorporation of thoracoscopic techniques and small but im¬
portant modifications to the technique have made this operation
very effective and safe.
Recontruction of Congenital Chest Wall Deformities
Using Solid Silicone Onlay Prostheses 341
Malcolm W. Marks and John Iacobucci
Congenital chest wall deformities include five types: pectus exca¬
vatum (funnel chest), pectus carinatum (pigeon breast), Poland s
syndrome, defects of sternal fusion, and miscellaneous dysplasias
and skeletal disorders. Of these five types, two, pectus excavatum
and Poland s syndrome, are defects of the skeletal chest wall.
These two specific anomalies comprise the vast majority of con¬
genital defects of the chest wall and, as depression deformities,
are readily amenable to surgical correction.
CONTENTS V
Surgical Treatment of Pectus Carinatum 357
Francis Robicsek
Pectus carinatum, just like its sister deformity pectus excavatum,
is a condition with an undefined developmental mechanism and
debated surgical techniques. Elongation of the costal cartilages
and elongation and anterior displacement of the sternum charac¬
terize the different varieties of pectus carniatum. Repair of the
anomaly involves positional correction as well as the shortening
of the sternum and the maintenance of its corrected position by
action of the rectus abdominis and pectoralis muscles.
Pouter Pigeon Breast 377
Alexander A. Fokin
Pouter pigeon breast is a rare congenital deformity of the chest
characterized by a protrusion of the manubriosternal junction and
adjacent costal cartilages as well as premature sternal ossification.
One third of the patients with pouter pigeon breast have the
concomitant depression of the lower sternum. Several cardiovas¬
cular abnormalities have been associated with premature sternal
ossification, the most common being the ventricular septal defect.
Surgical correction includes the wide wedge transverse sternot
omy at the angle of Louis and subperichondrial resection of the
adjacent costal cartilages. Long term outcomes are encouraging.
Poland s Syndrome 393
Harold C. Urschel, Jr
Poland s syndrome is characterized by hypoplasia or absence of
the breast or nipple, hypoplasia of subcutaneous tissue, absence
of the costosternal portion of the pectoralis major muscle, absence
of the pectoralis minor muscle, and absence of costal cartilages
or ribs 2, 3, and 4 or 3, 4, and 5. Clinical manifestations of
Poland s syndrome are extremely variable and rarely are all the
features recognized in one individual. Depending on the physi¬
cian s specialty and the referral pattern, a variable incidence of
the anomalous defects is recognized. Syndactyly or bony abnor¬
malities of the forearm are seldom treated by thoracic surgeons.
Simultaneous Pectus and Open Heart Surgery 405
Alexander Tschirkov, Bojan Baev, and Rumen Iliev
Various surgical approaches to pectus excavatum repair concomi¬
tant with surgery have been recommended. In this article the
authors describe their approach to the problem that they applied
in 1989 and onward, successfully, in six consecutive patients. The
favorable early and long term results of these cases illustrate
that the simultaneous correction of pectus excavatum and the
underlying diseases of the ascending aorta, aortic arch, and the
viii contents
heart can be performed successfully even in emergency situations.
The technique recommended provides good cosmetic results and
a stable chest wall. It is well applicable in patients of adult age.
Complications of Surgery for Pectus Excavatum 415
J. Alex Haller, Jr
The article describes the various acute and late complications of
surgery for pectus excavatum. Because the acute complications
are well known and easily managed and the late complications
can be prevented, operative correction of pectus excavatum can
be recommended to parents and their children with severe de¬
formities with very little risk and a realistic expectation of good
long term correction.
Scoliosis in Children with Anterior Chest Wall
Deformities 427
Steven L. Frick
This article reviews the available literature regarding scoliosis
associated with anterior chest wall deformities in children. The
prevalence, etiologic theories, natural history, and treatment of
scoliosis associated with pectus deformities are discussed. Syn¬
dromes that include both scoliosis and chest wall deformities are
described.
Index 437
Subscription Information Inside back cover
CONTENTS **
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| spelling | Surgical treatment of anterior chest wall deformities Francis Robicsek, guest ed. Philadelphia [u.a.] Saunders 2000 XII S., S. 227 - 439 Ill. txt rdacontent n rdamedia nc rdacarrier Chest surgery clinics of North America 10,2 Poland, syndrome - Chirurgie Thorax - Chirurgie Thorax en entonnoir - Chirurgie Chirurgie (DE-588)4009987-8 gnd rswk-swf Thoraxdeformität (DE-588)4254083-5 gnd rswk-swf Trichterbrust (DE-588)4186076-7 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Trichterbrust (DE-588)4186076-7 s Chirurgie (DE-588)4009987-8 s DE-604 Thoraxdeformität (DE-588)4254083-5 s Robicsek, Francis Sonstige oth Chest surgery clinics of North America 10,2 (DE-604)BV005455558 10,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008978516&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Surgical treatment of anterior chest wall deformities Chest surgery clinics of North America Poland, syndrome - Chirurgie Thorax - Chirurgie Thorax en entonnoir - Chirurgie Chirurgie (DE-588)4009987-8 gnd Thoraxdeformität (DE-588)4254083-5 gnd Trichterbrust (DE-588)4186076-7 gnd |
| subject_GND | (DE-588)4009987-8 (DE-588)4254083-5 (DE-588)4186076-7 (DE-588)4143413-4 |
| title | Surgical treatment of anterior chest wall deformities |
| title_auth | Surgical treatment of anterior chest wall deformities |
| title_exact_search | Surgical treatment of anterior chest wall deformities |
| title_full | Surgical treatment of anterior chest wall deformities Francis Robicsek, guest ed. |
| title_fullStr | Surgical treatment of anterior chest wall deformities Francis Robicsek, guest ed. |
| title_full_unstemmed | Surgical treatment of anterior chest wall deformities Francis Robicsek, guest ed. |
| title_short | Surgical treatment of anterior chest wall deformities |
| title_sort | surgical treatment of anterior chest wall deformities |
| topic | Poland, syndrome - Chirurgie Thorax - Chirurgie Thorax en entonnoir - Chirurgie Chirurgie (DE-588)4009987-8 gnd Thoraxdeformität (DE-588)4254083-5 gnd Trichterbrust (DE-588)4186076-7 gnd |
| topic_facet | Poland, syndrome - Chirurgie Thorax - Chirurgie Thorax en entonnoir - Chirurgie Chirurgie Thoraxdeformität Trichterbrust Aufsatzsammlung |
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