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Does repair of pectus excavatum improve cardiopulmonary function?

Jayaramakrishnan, Kumara and Wotton, Robin and Bradley, Amy and Naidu, Babu (2013) Does repair of pectus excavatum improve cardiopulmonary function? Interactive cardiovascular and thoracic surgery. ISSN 1569-9285.

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Official URL: http://icvts.oxfordjournals.org/content/early/2013...

Abstract

A best evidence topic was written according to a structured protocol. The question addressed was 'Does repair of pectus excavatum (PE) improve cardiopulmonary function?' One hundred and sixty-eight papers were found using the reported search, 19 level III evidence papers and three meta-analyses were relevant. Studies were divided into four groups based on the surgical technique applied and pulmonary and cardiac functions in these groups were analysed. The meta-analyses show conflicting results for improvements in pulmonary and cardiac functions when comparing surgical techniques, while four more recent studies show improved long-term results using the Nuss technique. The best evidence of papers studying the PE repair using the minimally invasive Nuss technique demonstrates a decrease in pulmonary function during the early postoperative period, however, there is a small but significant improvement during the late postoperative period and after bar removal. The best evidence for cardiac function in this group suggests an early improvement that is sustained during further follow-up. The best evidence of papers studying the PE repair using the Ravitch technique shows that pulmonary function decreased during the early postoperative period, however, there is a small but significant improvement during the late postoperative period. The best evidence for cardiac function in this group suggests an early improvement that is sustained during further follow-up. The best evidence of papers studying the PE repair using other techniques (modified Daniel's technique, modified Baronofsky's technique, sterno-costal turn-over technique and sterno-costal elevation technique) or where surgical techniques used were not described (preceding year 1985) suggests that there is no improvement in pulmonary function after surgery. There is some evidence that certain aspects of cardiac function improved after surgery in this group.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Planned IP Care > Thoracic Surgery
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Depositing User: Mrs Liz Lees
Date Deposited: 25 Apr 2013 10:52
Last Modified: 25 Apr 2013 10:52
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/21

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