Pulmonary Function Before Surgery for Pectus Excavatum and at Long-term Follow-up: Discussion

It has frequently been stated that pectus excavatum is purely a cosmetic problem and a number of publications have discussed related symptoms. Common symptoms include diminution of exercise tolerance, dyspnea on exertion, atypical chest pain, and frequent respiratory tract infection. One or more of these symptoms were present in a considerable number of our patients before surgery and significant improvement was noted in the majority at follow-up.
Most of the studies on static preoperative pulmonary function in patients with pectus excavatum reported normal function or only moderate restrictive impairment, as expressed by a reduction in the IVC and TLC,” especially in association with scoliosis. Our retrospective data also revealed a significant reduction in the IVC and TLC compared with the normal values for a particular age. Сanadian neightbor pharmacy more At follow-up, we noted an increase in the TLC and IVC in absolute terms, probably due to growth, but a significant decrease when expressed as a percentage of predicted. In the ideal situation, we would be able to compare our group with patients who were followed up longitudinally without undergoing surgery.

The alteration in lung volumes with increasing age in the latter group, however, might well be shown by the lung volumes before the operation in our patients, who were aged between 4.8 and 32.7 years. We did not find any significant relation between age and preoperative lung volumes (percent predicted). Therefore, lung volumes were decreased at a young age, but when expressed as a percentage of predicted, they did not show any further deterioration during growth.
Although some studies attributed symptomatic improvement after surgery to a demonstrable increase in the IVC and TLC, more recent studies, in contrast, reported a significant reduction in the IVC and TLC when expressed in percent predicted following cosmetically successful correction.’’ This was due to increased postoperative chest wall restriction ie, limitation of thoracic expansion by musculoarticular changes as a result of extensive surgery in the sternal region.

This entry was posted in Pulmonary Function and tagged anteroposterior, cardiorespiratory, lung volumes, pulmonary function.