Short and long term outcomes of using cryoablation for postoperative pain control in patients after pectus excavatum repair.

Creator(s)

James Fraser, Children's Mercy HospitalFollow
Kayla B. Briggs, Children's Mercy HospitalFollow
Wendy Jo Svetanoff, Children's Mercy Kansas City
Pablo Aguayo, Children's Mercy HospitalFollow
David Juang, Children's Mercy HospitalFollow
Jason D. Fraser, Children's Mercy HospitalFollow
Charles L. Snyder, Children's Mercy HospitalFollow
Tolulope A. Oyetunji MD MPH, Children's Mercy Kansas CityFollow
Shawn D. St Peter, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

6-2022

Identifier

DOI: 10.1016/j.jpedsurg.2022.01.051

Abstract

INTRODUCTION: We report the findings of a three-year prospective observational study elucidating long-term symptoms and complications of patients who underwent minimally invasive pectus excavatum repair with intercostal nerve cryoablation with specific attention to postoperative pain control associated with the cryoablation technique.

METHODS: Surveys were administered to patients who underwent bar placement for pectus excavatum with intercostal nerve cryoablation from 2017 to 2021 regarding pain scores, pain medication usage, and limitations to activity beginning on the day of surgery, on the day of discharge, and at two-week and three-month follow-up.

RESULTS: Of 110 patients, forty-eight (44%) completed the discharge survey; sharp pain and pressure on the first postoperative night were the most described pain characteristics, most frequently in the middle of the chest. On follow-up, 55% of patients reported tolerable residual pain at two weeks and 41% at three months, with 25% requiring intermittent pain medication at three months. There were three readmissions for inadequate pain control and 110 calls to the surgery clinic by three-month follow-up, most commonly for persistent pain and frequent popping sensation with movement.

DISCUSSION: Although cryoablation is an excellent pain control modality, these data suggest that patients underreport functional symptoms and experience more frequent discomfort and alteration of daily living activities.

Journal Title

Journal of pediatric surgery

Volume

57

Issue

6

First Page

1050

Last Page

1055

MeSH Keywords

Cryosurgery; Funnel Chest; Humans; Intercostal Nerves; Minimally Invasive Surgical Procedures; Pain, Postoperative; Retrospective Studies; Treatment Outcome

Keywords

Intercostal cryoablation; Nuss bar; Nuss procedure; Pectus excavatum; Thoracoscopy

Recommended Citation

Fraser JA, Briggs KB, Svetanoff WJ, et al. Short and long term outcomes of using cryoablation for postoperative pain control in patients after pectus excavatum repair. J Pediatr Surg. 2022;57(6):1050-1055. doi:10.1016/j.jpedsurg.2022.01.051