Pulmonary function before and after the Nuss procedure in adolescents with pectus excavatum: correlation with morphological subtypes

Journal of Cardiothoracic Surgery

Keon Hyon Jo²  Sung Bo Sim³  Kyungdo Han⁵  Yoon Hong Chun⁴  Sang Yong Kim⁴  Joong Hyun Ahn⁶  Jin Yong Jeong¹ 

[1] Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;Department of Thoracic and Cardiovascular Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;Department of Pediatrics, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea;Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea;Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

关键词: Adolescents;    Pulmonary function test;    Pectus excavatum;   

Others  :  1145491
DOI  :  10.1186/s13019-015-0236-7

 received in 2014-11-26, accepted in 2015-03-11,  发布年份 2015

【 摘 要 】

Background

Differences in post-Nuss procedure pulmonary function based on the pectus excavatum subtype have not been investigated in adolescents. We evaluated differences in pulmonary function before and after the Nuss procedure according to preoperative morphology.

Methods

We performed a retrospective review of eighteen male patients who had undergone the Nuss procedures. There were nine patients each with symmetric and asymmetric morphology. Patients were younger than 18 years and had no history of respiratory diseases. Pulmonary function was assessed 2 weeks before and 4–6 months after the surgery. Preoperative and postoperative pulmonary function data were compared between the symmetric and asymmetric types. The paired t-test was used to compare the differences within each group and an analysis of covariance (ANCOVA) was used to access intergroup differences.

Results

There were no significant demographic differences between patients with symmetric and asymmetric subtypes. Patients with the asymmetric type had a lower preoperative total lung capacity (TLC) (p = 0.018), vital capacity (VC) (p = 0.0308), and inspiratory capacity (IC) (p = 0.0373). In both types, the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and VC were all significantly decreased postoperatively compared to baseline (all, p < 0.01). The asymmetric type showed further reductions in peak expiratory flow (PEF) (p = 0.0391) and IC (p = 0.0084) postoperatively. The residual volume (RV) (p = 0.0092) and RV/TLC ratio (p = 0.0025) increased significantly in the asymmetric type, but only the postoperative PEF values differed significantly between the two types (p = 0.0151).

Conclusions

The asymmetric type had poorer preoperative lung volumes and poorer postoperative pulmonary function, with significantly lower PEF compared to the symmetric type cases. Preoperative and postoperative lung function needs more careful evaluation until pectus bar removal in the asymmetric type of pectus excavatum.

【 授权许可】

   
2015 Jeong et al.; licensee BioMed Central.

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