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Non-prosthetic Surgical Repair for Pectus Deformities

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Chest Wall Deformities
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Chest wall malformations (CWMs) represent a wide range of pathologies. Pectus excavatum and carinatum anomalies are the most common. Considering the importance of evaluate the benefits and the limitations of each technique, surgical procedures and postoperative cares have developed. The use of a metal bar for sternal stabilization was introduced in 1956 and remains the most widely used. In recent years a minimally invasive technique of pectus excavatum repair using a convex steel bar to force the sternum forwards has gained popularity. A number of complications have been reported with the use of the metal bar, notably displacement (5.8 %), allergy to the bar (2.9 %) and excavatum overcorrection (3.2 %). Other less frequent complications include prosthesis infection, pneumonia, pleural effusion, haemothorax, wound seroma, skin necrosis, pericarditis and cardiac perforation. An additional operation is also required to remove the bar. Recently some authors have described a prosthesis-free technique for the surgical treatment of pectus excavatum, in which the position of the sternum is supported by the attachment to the overlying muscle raphe holding it in the desired position, assisted by maintenance of good posture after surgery. This produce a stable repair with no evidence of a postoperative flail chest. This technique has been utilised for the surgical treatment of pectus carinatum too. The only limitation is the short follow-up (under 4 years). Long-term follow-up will determine the durability of the techniques.

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Correspondence to Ciro Esposito MD .

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Giurin, I., Esposito, C. (2017). Non-prosthetic Surgical Repair for Pectus Deformities. In: Saxena, A. (eds) Chest Wall Deformities. Springer, Berlin, Heidelberg.

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