Title

Evaluation of pectus bar position and osseous bone formation.

Document Type

Article

Publication Date

6-1-2003

Abstract

PURPOSE: Minimally invasive repair has become a popular approach for pectus excavatum (PE). The bar is secured to the thoracic wall and left for approximately 2 years. The authors have noticed an intense bone formation (BF) around some of these bars at removal. A review of children undergoing bar removal was performed to better understand this BF in relation to bar placement.

METHODS: A retrospective review of children undergoing bar removal after PE repair since January 1998 was performed. Chart review included age at bar insertion and removal, bar insertion position (subcutaneous [SC] v submuscular [SM]), BF on Chest x-ray and at bar removal, operating time, and estimated blood loss (EBL).

RESULTS: Thirty-six patients underwent bar removal during the study period (16 SC and 20 SM). Chest x-ray evaluation was possible in 27 patients (16 SM, 11 SC). No difference existed for length of time the bar was in place or age at insertion/removal between groups. EBL was higher in the SM (18.3 v 8.8 mL, not significant). BF was seen radiographically in 15 SM and 3 SC patients (P

CONCLUSIONS: Bar position during repair of PE is important. SM positioning virtually always results in BF with increased EBL and statistically longer operating time at removal. Careful placement of the bar in the SC position without violating the fascia should be used to avoid these undesirable effects.

Journal Title

Journal of pediatric surgery

Volume

38

Issue

6

First Page

953

Last Page

956

MeSH Keywords

Blood Loss, Surgical; Child; Device Removal; Foreign-Body Reaction; Funnel Chest; Humans; Length of Stay; Osteogenesis; Prostheses and Implants; Radiography; Retrospective Studies; Thoracic Surgical Procedures; Time Factors

Keywords

Children

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