Article Abstract

Elastic stable chest repair and its hybrid variants in 86 patients with pectus excavatum

Authors: Stefan Schulz-Drost, Anna Maria Luber, Kirsten Simon, Melanie Schulz-Drost, Julia Syed, Roman T. Carbon, Manuel Besendörfer


Background: Complex and mature funnel chest deformities are traditionally managed with open surgical procedures. Elastic stable chest repair (ESCR) has been used successfully and safely for relapse corrections. Does pure plate osteosynthesis in ESCR allow comparable corrective potency and implant safety as hybrid methods with metal bars?
Methods: Data from 86 patients with open funnel chest correction between 2011 and 2015 were analyzed in this retrospective study. Exclusion criteria included being under 12 years of age, and having a history of septic wound healing disorder or other malignant diseases. Main groups consisted of ESCR and hybrid techniques, subgroups were primary and recurrence correction. Correction results and follow-up examinations at six and 12 weeks and at 1 year were statistically analyzed.
Results: A total of 38 ESCR and 48 hybrid methods were analyzed. Bar implantation was required in 77% (recurrence 34%) of patients. All patients received plates with different combinations e.g., longitudinal-sternal, costosternal and costo-sterno-costal. In all groups, follow-up uptake showed a funnel chest correction result at the anatomical level with healthy values according to the Haller index (ESCR 4.36–2.84, hybrid 6.99–2.74, P<0.001). No material dislocations were observed in any subgroup.
Conclusions: ESCR and hybrid techniques represent promising and safe therapeutic approaches.