Title

Routine use of chest radiographs in the post-operative management of pectus bar removal: necessity or futility.

Document Type

Article

Publication Date

5-1-2017

Identifier

DOI: 10.1007/s00383-017-4057-8

Abstract

BACKGROUND: While there is literature on techniques for pectus bar removal, there are limited reports on post-operative management. This can include obtaining a postoperative chest radiograph (CXR) despite the minimal risk of associated intra-thoracic complications. This is a review of our experience with bar removal and lack of routine post-operative CXR.

METHODS: A single institution retrospective chart review was performed from 2000 to 2015. Patients who underwent a pectus bar removal procedure were included. We assessed operative timing of bar placement and removal, procedure length, intra-operative and post-operative complications and post-operative CXR findings, specifically the rate of pneumothoraces.

RESULTS: 450 patients were identified in this study. Median duration of bar placement prior to removal was 35 months (interquartile range 30 and 36 months). Sixtey-four patients obtained a post-operative CXR. Of these, only one (58%) film revealed a pneumothorax; this was not drained. A CXR was not obtained in 386 (86%) patients with no immediate or delayed complications from this practice. Median follow-up time for all patients was 11 months (interquartile range 7.5-17 months).

DISCUSSION: The risk for a clinically relevant pneumothorax is minimal following bar removal. This suggests that not obtaining routine imaging following bar removal may be a safe practice.

Journal Title

Pediatric surgery international

Volume

33

Issue

5

First Page

619

Last Page

622

MeSH Keywords

Adolescent; Female; Follow-Up Studies; Funnel Chest; Humans; Male; Operative Time; Pneumothorax; Postoperative Care; Postoperative Complications; Radiography, Thoracic; Retrospective Studies; Time Factors

Keywords

Bar removal; Chest radiograph; Chest x-ray; Pectus bar; Post-operative complications

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