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Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature

Yıl 2016, Cilt: 1 Sayı: 1, 21 - 27, 28.12.2016

Öz

Background: The main subtypes of chest wall deformities are pectus excavatum (PE) and pectus carinatum (PC). Although these are not life threatening diseases, some functional or physico-social disabilities due to the abnormal chest wall structure require treatment. The main stem of the treatment is surgical correction. Since the beginning of the 20th century various surgical techniques were introduced. In the last few decades some minimally invasive surgical techniques were also described. In the English literature many reports suggest that the vast majority of these abnormalities are PE. But in most of the reports patient groups consist of hospital admissions. The real frequency of this group of disease is controversial.


Materials and Methods: In this report, a wide field study was designed to find the real frequency of the chest wall diseases. Total of 25117 children between 6-11 years of age were visited in the elementary schools of Kahramanmaraş. The team members were a thoracic surgeon, a pulmonologist and a pediatrician.


Results: A careful physical examination revealed that a total of 255 patients had different degrees of chest wall deformity. We found that PC (90.58%) was the most frequent type of deformity in contrast with the previous reports suggesting PE as the most frequent type. In our results only 5.49% of the patients had PE and 3.93% of the patients had mixed type PE+PC. The most frequent ECG abnormality seen in 49 cases (19% of cases with deformity) was a negative T wave on V1 derivation and a biphasic T wave configuration on V1-V2 derivations. 8 patients (3.13%) had concomitant scoliosis and 6 patients (%2.35) had different degrees of cardiomegaly.


Conclusions: The real frequency of chest wall deformities is an enigma. When PE patients themselves or their family notice the abnormality, they may consider it as a big health problem and admit to a healthcare unit. But in contrast, PC patients mostly do not care about this disorder until adolescence, so admission rate is less then PE. We suggest that the real frequency of the chest wall deformities may be found only by widespread field studies. Moreover, we found more accompanying cardiac disorders in PC group, and this type of screening may allow early diagnosis of some cardiac diseases.

Kaynakça

  • The use of soft silicone solid implant molded intraoperative for pectus excavatum surgical repair. Einstein 2014; 12: 86-90.
  • Saxena AK. Pectus excavatum, pectus carinatum and other forms of thoracic deformities. J Indian Assoc Pediatr Surg 2005; 10: 147-57.
  • Kuru P, Cakiroglu A, Er A, Ozbakir H, Cinel AE, Cangut B, et al. Pectus excavatum and pectus carinatum: Associated conditions, family history, and postoperative patient satisfaction. Korean J Thorac Cardiovasc Surg 2016; 49: 29-34.
  • Brochhausena C, Turialb S, Müllera KF, Schmitta VH, Coerdta W, Wihlmc JM, et al. Pectus excavatum: history, hypotheses and treatment options. Interact Cardiovasc Thorac Surg 2012; 14: 801–6.
  • Robicsek F, Watts LT, Fokin AA. Surgical Repair of pectus excavatum and carinatum. Semin Thorac Cardiovasc Surg 2009; 21: 64-75.
  • de Matos AC, Bernardo JE, Fernandes LE, Antunes MJ. Surgery of chest wall deformities. Eur J Cardiothorac Surg 1997; 12: 345-50.
  • Nuss D, Kelly RE, Crotioru DP, Katz ME. A 10 year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg, 1998; 33: 545-52.
  • Yuksel M, Bostanci K, Evman S. Minimally invasive repair after inefficient open surgery for pectus excavatum. Eur J Cardiothorac Surg 2011; 40: 625-9.
  • Yucesan S, Dındar H, Olcay I, Okur H, Kilicaslan, S, Ergoren Y, et al. Prevalence of congenital abnormalities in Turkish school children Eur J Epidemiol 1993; 9: 373-80.
  • Esme H, Bukulmez A, Dogru O, Solak O. Prevalence of chest wall deformities in primary school children of Afyon city. Turkish J Thorac Cardiovasc Surg 2006; 14: 34-7.
  • Goretsky MJ, Kelly RE, Jr, Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med 2004; 15: 455-71.
  • Jaroszewski D, Notrica D, McMahon L, Steidley E, Deschamps C. Current management of pectus excavatum: A review and update of therapy and treatment recommendations. JABFM 2010; 23: 230-39.
  • Wu S, Sun X, Zhu W, Huang Y, Mou L, Liu M, et al. Evidence for GAL3ST4 mutation as the potential cause of pectus excavatum. Cell Res 2012; 22: 1712-5.
  • Tocchioni F,Ghionzoli M, MessineoA, Romagnoli P. Pectus excavatum and heritable disorders of the connective tissue. Pediatric Reports 2013; 5: 58-63.
  • Johnson WR, Fedor D, Singhal S. Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum. J Cardiothorac Surg 2014, 9: 25.
  • Oezcan S, Attenhofer Jost CH, Pfyffer M, Kellenberger C, Jenni R, Binggeli C, et al. Pectus excavatum echocardiography and cardiac MRI reveal frequent pericardial effusion and right-sided heart anomalies. Eur Heart J Cardiovasc Imaging 2012; 13: 673-9.
  • Töpper A, Polleichtner S, Zagrosek A, Prothmann M, Traber J, Schwenke C, et al. Impact of surgical correction of pectus excavatum on cardiac function: insights on the right ventricle. A cardiovascular magnetic resonance study. Interact CardioVasc Thorac Surg 2016; 22: 38-46.
  • Haller JA, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: A preliminary report. J Pediatr Surg 1987; 22: 904-6.
  • Zhang DK, Tang JM, Ben XM, Xie L, Zhou HY, Ye X, et al. Surgical correction of 639 pectus excavatum cases via the Nuss Procedure. J Thorac Dis 2015; 7: 1595-605.
  • Ravitch MM. The operative treatment of pectus excavatum. Ann Surg 1949; 129: 429-44.
  • Wada J, Ikeda K , Ishida T, Hasegawa T. Results of 271 funnel chest operations. Ann Thorac Surg 1970; 10: 526-32.
  • Robicsek F. Marlex mesh support for the correction of very severe and recurrent pectus excavatum. Ann Thorac Surg 1978; 26: 80-3.
  • Gurkok S, Genc O, Dakak M, Balkanli K. The use of absorbable material in correction of pectus deformities. Eur J Cardiothorac Surg 2001; 19:711-2.
  • Ozpolat B, Soyal T, Gokaslan G, Tophanelioglu T, Sarigül A,Yücel E. Surgical correction of pectus excavatum and carinatum deformities: evaluation of 30 cases. Turkish J Thorac Cardiovasc Surg 2005; 13: 270-3.
  • Cheng YL, Lin CT, Wang HB, Chang H. Pleural Effusion Complicating after Nuss Procedure for pectus excavatum. Ann Thorac Cardiovasc Surg 2014; 20: 6-11.
  • Sa YJ, Lee J, Jeong JY, Choi M, Park SS, Sim SB, et al. A clinical decision-making model for repeat surgical treatment of pectus Bar displacement: distance measurement after nuss procedure. J Cardiothorac Surg 2016; 11: 16.
  • Coelho S, Guimaraes S. Pectus carinatum. J Bras Pneumol 2007; 33: 463-74.
  • Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin 2010; 20: 563-74.
  • Fonkalsrud EW. Pectus Carinatum: The undertreated chest malformation. Asian J Surg 2003; 26: 189-92.
  • Parka CH, Kima TH, Haamb SJ, Lee S. Does overgrowth of costal cartilage cause pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric pectus carinatum. Interact Cardiovasc Thorac Surg 2013; 17: 757-63.
  • Abramson H, D'Agostino J, Wuscovi S. A 5-year experience with a minimally invasive technique for pectus carinatum repair. J Pediatr Surg 2009; 44:118-24.
  • Yuksel M, Bostanci K, Evman S. Minimally invasive repair of pectus carinatum using a newly designed bar and stabilizer: a single-institution experience. Eur J Cardiothorac Surg 2011; 40: 339-42.
Yıl 2016, Cilt: 1 Sayı: 1, 21 - 27, 28.12.2016

Öz

Kaynakça

  • The use of soft silicone solid implant molded intraoperative for pectus excavatum surgical repair. Einstein 2014; 12: 86-90.
  • Saxena AK. Pectus excavatum, pectus carinatum and other forms of thoracic deformities. J Indian Assoc Pediatr Surg 2005; 10: 147-57.
  • Kuru P, Cakiroglu A, Er A, Ozbakir H, Cinel AE, Cangut B, et al. Pectus excavatum and pectus carinatum: Associated conditions, family history, and postoperative patient satisfaction. Korean J Thorac Cardiovasc Surg 2016; 49: 29-34.
  • Brochhausena C, Turialb S, Müllera KF, Schmitta VH, Coerdta W, Wihlmc JM, et al. Pectus excavatum: history, hypotheses and treatment options. Interact Cardiovasc Thorac Surg 2012; 14: 801–6.
  • Robicsek F, Watts LT, Fokin AA. Surgical Repair of pectus excavatum and carinatum. Semin Thorac Cardiovasc Surg 2009; 21: 64-75.
  • de Matos AC, Bernardo JE, Fernandes LE, Antunes MJ. Surgery of chest wall deformities. Eur J Cardiothorac Surg 1997; 12: 345-50.
  • Nuss D, Kelly RE, Crotioru DP, Katz ME. A 10 year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg, 1998; 33: 545-52.
  • Yuksel M, Bostanci K, Evman S. Minimally invasive repair after inefficient open surgery for pectus excavatum. Eur J Cardiothorac Surg 2011; 40: 625-9.
  • Yucesan S, Dındar H, Olcay I, Okur H, Kilicaslan, S, Ergoren Y, et al. Prevalence of congenital abnormalities in Turkish school children Eur J Epidemiol 1993; 9: 373-80.
  • Esme H, Bukulmez A, Dogru O, Solak O. Prevalence of chest wall deformities in primary school children of Afyon city. Turkish J Thorac Cardiovasc Surg 2006; 14: 34-7.
  • Goretsky MJ, Kelly RE, Jr, Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med 2004; 15: 455-71.
  • Jaroszewski D, Notrica D, McMahon L, Steidley E, Deschamps C. Current management of pectus excavatum: A review and update of therapy and treatment recommendations. JABFM 2010; 23: 230-39.
  • Wu S, Sun X, Zhu W, Huang Y, Mou L, Liu M, et al. Evidence for GAL3ST4 mutation as the potential cause of pectus excavatum. Cell Res 2012; 22: 1712-5.
  • Tocchioni F,Ghionzoli M, MessineoA, Romagnoli P. Pectus excavatum and heritable disorders of the connective tissue. Pediatric Reports 2013; 5: 58-63.
  • Johnson WR, Fedor D, Singhal S. Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum. J Cardiothorac Surg 2014, 9: 25.
  • Oezcan S, Attenhofer Jost CH, Pfyffer M, Kellenberger C, Jenni R, Binggeli C, et al. Pectus excavatum echocardiography and cardiac MRI reveal frequent pericardial effusion and right-sided heart anomalies. Eur Heart J Cardiovasc Imaging 2012; 13: 673-9.
  • Töpper A, Polleichtner S, Zagrosek A, Prothmann M, Traber J, Schwenke C, et al. Impact of surgical correction of pectus excavatum on cardiac function: insights on the right ventricle. A cardiovascular magnetic resonance study. Interact CardioVasc Thorac Surg 2016; 22: 38-46.
  • Haller JA, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: A preliminary report. J Pediatr Surg 1987; 22: 904-6.
  • Zhang DK, Tang JM, Ben XM, Xie L, Zhou HY, Ye X, et al. Surgical correction of 639 pectus excavatum cases via the Nuss Procedure. J Thorac Dis 2015; 7: 1595-605.
  • Ravitch MM. The operative treatment of pectus excavatum. Ann Surg 1949; 129: 429-44.
  • Wada J, Ikeda K , Ishida T, Hasegawa T. Results of 271 funnel chest operations. Ann Thorac Surg 1970; 10: 526-32.
  • Robicsek F. Marlex mesh support for the correction of very severe and recurrent pectus excavatum. Ann Thorac Surg 1978; 26: 80-3.
  • Gurkok S, Genc O, Dakak M, Balkanli K. The use of absorbable material in correction of pectus deformities. Eur J Cardiothorac Surg 2001; 19:711-2.
  • Ozpolat B, Soyal T, Gokaslan G, Tophanelioglu T, Sarigül A,Yücel E. Surgical correction of pectus excavatum and carinatum deformities: evaluation of 30 cases. Turkish J Thorac Cardiovasc Surg 2005; 13: 270-3.
  • Cheng YL, Lin CT, Wang HB, Chang H. Pleural Effusion Complicating after Nuss Procedure for pectus excavatum. Ann Thorac Cardiovasc Surg 2014; 20: 6-11.
  • Sa YJ, Lee J, Jeong JY, Choi M, Park SS, Sim SB, et al. A clinical decision-making model for repeat surgical treatment of pectus Bar displacement: distance measurement after nuss procedure. J Cardiothorac Surg 2016; 11: 16.
  • Coelho S, Guimaraes S. Pectus carinatum. J Bras Pneumol 2007; 33: 463-74.
  • Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin 2010; 20: 563-74.
  • Fonkalsrud EW. Pectus Carinatum: The undertreated chest malformation. Asian J Surg 2003; 26: 189-92.
  • Parka CH, Kima TH, Haamb SJ, Lee S. Does overgrowth of costal cartilage cause pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric pectus carinatum. Interact Cardiovasc Thorac Surg 2013; 17: 757-63.
  • Abramson H, D'Agostino J, Wuscovi S. A 5-year experience with a minimally invasive technique for pectus carinatum repair. J Pediatr Surg 2009; 44:118-24.
  • Yuksel M, Bostanci K, Evman S. Minimally invasive repair of pectus carinatum using a newly designed bar and stabilizer: a single-institution experience. Eur J Cardiothorac Surg 2011; 40: 339-42.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Mahmut Tokur Bu kişi benim

Şevki Mustafa Demiöz

Muhammet Sayan Bu kişi benim

Naime Tokur Bu kişi benim

Hüseyin Arpağ Bu kişi benim

Yayımlanma Tarihi 28 Aralık 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 1 Sayı: 1

Kaynak Göster

APA Tokur, M., Demiöz, Ş. M., Sayan, M., Tokur, N., vd. (2016). Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature. CURRENT THORACIC SURGERY, 1(1), 21-27.
AMA Tokur M, Demiöz ŞM, Sayan M, Tokur N, Arpağ H. Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature. CTS. Aralık 2016;1(1):21-27.
Chicago Tokur, Mahmut, Şevki Mustafa Demiöz, Muhammet Sayan, Naime Tokur, ve Hüseyin Arpağ. “Chest Wall Deformities and Coincidence of Additional Anomalies, Screening Results of the 25.000 Turkish Children With the Review of the Literature”. CURRENT THORACIC SURGERY 1, sy. 1 (Aralık 2016): 21-27.
EndNote Tokur M, Demiöz ŞM, Sayan M, Tokur N, Arpağ H (01 Aralık 2016) Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature. CURRENT THORACIC SURGERY 1 1 21–27.
IEEE M. Tokur, Ş. M. Demiöz, M. Sayan, N. Tokur, ve H. Arpağ, “Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature”, CTS, c. 1, sy. 1, ss. 21–27, 2016.
ISNAD Tokur, Mahmut vd. “Chest Wall Deformities and Coincidence of Additional Anomalies, Screening Results of the 25.000 Turkish Children With the Review of the Literature”. CURRENT THORACIC SURGERY 1/1 (Aralık 2016), 21-27.
JAMA Tokur M, Demiöz ŞM, Sayan M, Tokur N, Arpağ H. Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature. CTS. 2016;1:21–27.
MLA Tokur, Mahmut vd. “Chest Wall Deformities and Coincidence of Additional Anomalies, Screening Results of the 25.000 Turkish Children With the Review of the Literature”. CURRENT THORACIC SURGERY, c. 1, sy. 1, 2016, ss. 21-27.
Vancouver Tokur M, Demiöz ŞM, Sayan M, Tokur N, Arpağ H. Chest wall deformities and coincidence of additional anomalies, screening results of the 25.000 Turkish children with the review of the literature. CTS. 2016;1(1):21-7.