Original article: general thoracicRepair of the pectus deformity: Results of the Ravitch approach in the current era
Section snippets
Patients and methods
Office records of the Department of Cardiothoracic Surgery at Children's Hospital in Columbus, Ohio were retrospectively reviewed for all patients undergoing repair of the pectus deformity from July 1991 through July 1, 2003. Operative notes and clinical data were reviewed for each patient including severity grading of the deformity. For reasons discussed below, we did not use preoperative CT scanning as an evaluation tool. The severity was expressed as a numerical expression of one observer's
Patient information
Records were sufficient for analysis in all 69 patients. Fifty-eight (84%) of the patients were male and 11 (16%) were female. Figure 1 shows the distribution of age at the time of surgery (median 14.5 years). All patients were made aware of both the Nuss and Ravitch approaches and the discussion included relative risks and benefits.
Indications for surgery are shown in Figure 2. In 26% of patients chest wall pain was the primary indication. In most cases, the pain was not consistently related
Comment
Many aspects of the repair of the pectus deformity remain controversial. Because evidence is conflicting concerning the pathophysiology of the deformity, consensus has never been reached about the indications for surgery. Unclear indications for surgery have led to difficulty in scientifically evaluating the outcomes after surgery. With the continuing development of different modalities of treatment in different centers, comparisons are difficult and further conclusions are elusive.
Our policy
Acknowledgements
The authors acknowledge the invaluable assistance of Mary Lou Naftzger for database analysis as well as Georgiana Roberts and Silva Gramlich for financial analysis and assistance. Anthony Baker provided Figure 4.
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Ravitch Surgery or Dynamic Compression Bracing for Pectus Carinatum: A Retrospective Cohort Study
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