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HOW TO SET UP ADOLESCENCE AND ADULT MINIMALLY INVASIVE CORRECTION OF PECTUS EXCAVIATUM PROGRAM
BACKGROUND
OUR UNITE DID TRADITIONAL RAVITCH OPERATION FOR PECTUS EXCAVATUM FOR YEARS. THIS OPERATION WAS INVASIVE WITH LARGE SCARS AND PROLONG HOSPITAL STAY AND AFTER CARE. IT WAS PAINFUL TO PATIENTS SO WE HAD TO CHANGE TO NEW APPROACH. NUSS PROCEDURE IN GROWN UPS GAVE VERY GOOD COSMETIC RESULTS.
METHOD
SINCE MID 2010 WE HAD 66 CASES WERE REFERRED. 2 CASES WITH VERY YOUNG CHILDREN WHICH WE REFERRED TO PAEDIATRIC HOSPITAL. AGE GROUP WAS 16-42 AVERAGE AGE OF 26. ONLY 2 FEMALES. HELLAR INDEX WAS BETWEEN 2.8 TO 5.2. ONE PATIENT HAD MARFAN SYNDROME. 1 CASE WAS REDO AFTER FAILED PREVIOUS OPERATION AT OTHER HOSPITAL. 30 PATIENTS HAVE UNDERGONE OPERATIONS . THE INITIAL CASES WERE DONE UNDER SUPERVISION OF EXPERT FROM DENMARK.(HP)
RESULTS
AVERAGE BAR USAGE WAS 1 BUT 10 PATIENT HAD 2 BARS. THESE WERE SHORT BARS. EXCEPT FOR 2 CASES ALL RECEIVED ONE STABILIZER.
AVERAGE PATIENT STAY WAS 2.5 DAYS. PAIN CONTROL WAS DONE WITH PATIENT CONTROLLED ANALGESIA FOR 2 DAYS AND 2 WEEKS OF ORAL TREATMENT.
TWO PATIENTS HAD POST OF PNEUMOTHORAX REQUIRING CHEST DRAIN. ONE PATIENT HAD DELAYED PLEURAL EFFUSION. ONE CASE HAD MINIMAL WOUND INFECTION. ONE PATIENT HAD MINIMAL DISPLACEMENT OF BAR. PATIENT SURVAY GAVE US EXCELLENT FEEDBACK.
CONCLUSION
SETTING UP NEW SERVICES CAN BE TIME CONSUMING BUT PROPER PLANNING AND SUPERVISION NEW INNOVATIVE TECHNIQUE CANE BE INTRODUCE WITH VERY LOW MORBIDITY AND WITH EXCELLENT RESULTS.