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A 20-year review of pectus surgery: An analysis of factors predictive of recurrence and outcomes

Tikka, T and Steyn, Richard and Bishay, Ehab and Kalkat, Maninder S and Naidu, Babu V and Rajesh, Pala B (2015) A 20-year review of pectus surgery: An analysis of factors predictive of recurrence and outcomes. In: 23rd European Conference on General Thoracic Surgery, 31 May – 3 June 2015, Lisbo, Portugal.

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Official URL: http://icvts.oxfordjournals.org/content/21/suppl_1...

Abstract

Objectives: We aimed to audit outcomes of pectus surgery and investigate potential predictive factors of pectus recurrence. Methods: A retrospective review of 297 patients who underwent repair of pectus deformity between 1994 and 2014. Patients medical records were reviewed for demographics; type of surgical correction; length of hospital stay; postoperative complications; pectus recurrence and duration of bar stay. Survival analysis methods and repeated events analysis were performed to identify predictor factor for pectus recurrence. Results: A total of 297 patients were included (262 males; 35 females), with a mean age of 19.8 years (range 9 to 45). Mean length of hospital stay was 4.7 days (range 1 to 21). Hundred and sixty-seven patients had surgery for pectus excavatum; 116 for carinatum. Hundred and fifty-three patients received a modified Ravitch without bar insertion; 72 with insertion of bar. Fifty-three patients underwent Nuss repair. Eighty-five patients had their bars removed, on an average of 18.5 months after surgery. The main complications were wound infection (3%) and postoperation bleeding (2.3%). Pectus recurrence rate was 9.4% (28/297). Type of operation was a highly significant factor of pectus first recurrence (P = 0.0002). A repeated event analysis, confirmed that patients treated with a bar were 2.7 times more likely to have further recurrences (P = 0.0078; 95% CI 1.3-5.8). In those patient treated with a bar, time of bar removal was a statistically significant predictive factor of first recurrence (P = 0.0112; OR: 1.054; 95% CI 1.054-1.011). Presence of postoperative complications only marginally failed to yield statistically significant results (P = 0.064). Conclusions: Pectus surgery can be performed with low morbidity. Type of operation, bar insertion and length of bar stay are predictive factors of pectus recurrence.

Item Type: Conference or Workshop Item (Poster)
Subjects: WG Cardiovascular system. Cardiology
Divisions: Emergency Services > Cardiology
Planned IP Care > Thoracic Surgery
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 16 Oct 2015 13:04
Last Modified: 16 Oct 2015 13:04
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1043

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