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Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments

OBJECTIVE: Minimally invasive repair of pectus excavatum (MIRPE) is a surgical treatment for PE. During the procedure, a specialized introducer is used to tunnel across the mediastinum for thoracoscopic insertion of a metal bar. There have been reported cases of cardiac perforation during this risky...

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Autores principales: Tedde, Miguel Lia, Togoro, Silvia Yukari, Eisinger, Robert Stephen, Okumura, Erica Mie, Fernandes, Angelo, Pêgo-Fernandes, Paulo Manuel, de Campos, Jose Ribas Milanez
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534412/
https://www.ncbi.nlm.nih.gov/pubmed/30758428
http://dx.doi.org/10.1590/1806-3713/e20170373
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author Tedde, Miguel Lia
Togoro, Silvia Yukari
Eisinger, Robert Stephen
Okumura, Erica Mie
Fernandes, Angelo
Pêgo-Fernandes, Paulo Manuel
de Campos, Jose Ribas Milanez
author_facet Tedde, Miguel Lia
Togoro, Silvia Yukari
Eisinger, Robert Stephen
Okumura, Erica Mie
Fernandes, Angelo
Pêgo-Fernandes, Paulo Manuel
de Campos, Jose Ribas Milanez
author_sort Tedde, Miguel Lia
collection PubMed
description OBJECTIVE: Minimally invasive repair of pectus excavatum (MIRPE) is a surgical treatment for PE. During the procedure, a specialized introducer is used to tunnel across the mediastinum for thoracoscopic insertion of a metal bar. There have been reported cases of cardiac perforation during this risky step. The large introducer can be a dangerous lever in unskilled hands. We set out to determine the safety and feasibility of using regular instruments (i.e., not relying on special devices or tools) to create the retrosternal tunnel during MIRPE. METHODS: This was a preliminary study of MIRPE with regular instruments (MIRPERI), involving 28 patients with PE. We recorded basic patient demographics, chest measurements, and surgical details, as well as intraoperative and postoperative complications. RESULTS: Patients undergoing MIRPERI had Haller index values ranging from 2.58 to 5.56. No intraoperative complications occurred. Postoperative complications included nausea/vomiting in 8 patients, pruritus in 2, and dizziness in 2, as well as atelectasis, pneumothorax with thoracic drainage, pleural effusion, and dyspnea in 1 patient each. CONCLUSIONS: In this preliminary study, the rate of complications associated with MIRPERI was comparable to that reported in the literature for MIRPE. The MIRPERI approach has the potential to improve the safety of PE repair, particularly for surgeons that do not have access to certain special instruments or have not been trained in their use.
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spelling pubmed-65344122019-06-12 Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments Tedde, Miguel Lia Togoro, Silvia Yukari Eisinger, Robert Stephen Okumura, Erica Mie Fernandes, Angelo Pêgo-Fernandes, Paulo Manuel de Campos, Jose Ribas Milanez J Bras Pneumol Original Article OBJECTIVE: Minimally invasive repair of pectus excavatum (MIRPE) is a surgical treatment for PE. During the procedure, a specialized introducer is used to tunnel across the mediastinum for thoracoscopic insertion of a metal bar. There have been reported cases of cardiac perforation during this risky step. The large introducer can be a dangerous lever in unskilled hands. We set out to determine the safety and feasibility of using regular instruments (i.e., not relying on special devices or tools) to create the retrosternal tunnel during MIRPE. METHODS: This was a preliminary study of MIRPE with regular instruments (MIRPERI), involving 28 patients with PE. We recorded basic patient demographics, chest measurements, and surgical details, as well as intraoperative and postoperative complications. RESULTS: Patients undergoing MIRPERI had Haller index values ranging from 2.58 to 5.56. No intraoperative complications occurred. Postoperative complications included nausea/vomiting in 8 patients, pruritus in 2, and dizziness in 2, as well as atelectasis, pneumothorax with thoracic drainage, pleural effusion, and dyspnea in 1 patient each. CONCLUSIONS: In this preliminary study, the rate of complications associated with MIRPERI was comparable to that reported in the literature for MIRPE. The MIRPERI approach has the potential to improve the safety of PE repair, particularly for surgeons that do not have access to certain special instruments or have not been trained in their use. Sociedade Brasileira de Pneumologia e Tisiologia 2019 /pmc/articles/PMC6534412/ /pubmed/30758428 http://dx.doi.org/10.1590/1806-3713/e20170373 Text en © 2019 Sociedade Brasileira de Pneumologia e Tisiologia https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Original Article
Tedde, Miguel Lia
Togoro, Silvia Yukari
Eisinger, Robert Stephen
Okumura, Erica Mie
Fernandes, Angelo
Pêgo-Fernandes, Paulo Manuel
de Campos, Jose Ribas Milanez
Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments
title Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments
title_full Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments
title_fullStr Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments
title_full_unstemmed Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments
title_short Back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments
title_sort back to the future: a case series of minimally invasive repair of pectus excavatum with regular instruments
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534412/
https://www.ncbi.nlm.nih.gov/pubmed/30758428
http://dx.doi.org/10.1590/1806-3713/e20170373
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