Jayaramakrishnan, K., Wotton, R., Bradley, A. and Naidu, Babu V. (2013) Does repair of pectus excavatum improve cardiopulmonary function? Interactive CardioVascular and Thoracic Surgery, Volume 16 (Number 6). pp. 865-870. doi:10.1093/icvts/ivt045 ISSN 1569-9293.

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Abstract

A best evidence topic was written according to a structured protocol. The question addressed was ‘Does repair of pectus excavatum (PE) improve cardiopulmonary function?’ One hundred and sixty-eight papers were found using the reported search, 19 level III evidence papers and three meta-analyses were relevant. Studies were divided into four groups based on the surgical technique applied and pulmonary and cardiac functions in these groups were analysed. The meta-analyses show conflicting results for improvements in pulmonary and cardiac functions when comparing surgical techniques, while four more recent studies show improved long-term results using the Nuss technique. The best evidence of papers studying the PE repair using the minimally invasive Nuss technique demonstrates a decrease in pulmonary function during the early postoperative period, however, there is a small but significant improvement during the late postoperative period and after bar removal. The best evidence for cardiac function in this group suggests an early improvement that is sustained during further follow-up. The best evidence of papers studying the PE repair using the Ravitch technique shows that pulmonary function decreased during the early postoperative period, however, there is a small but significant improvement during the late postoperative period. The best evidence for cardiac function in this group suggests an early improvement that is sustained during further follow-up. The best evidence of papers studying the PE repair using other techniques (modified Daniel's technique, modified Baronofsky's technique, sterno-costal turn-over technique and sterno-costal elevation technique) or where surgical techniques used were not described (preceding year 1985) suggests that there is no improvement in pulmonary function after surgery. There is some evidence that certain aspects of cardiac function improved after surgery in this group

Item Type:	Journal Article
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	Interactive CardioVascular and Thoracic Surgery
Publisher:	Oxford University Press
ISSN:	1569-9293
Official Date:	2013
Dates:	Date Event 2013 Published
Volume:	Volume 16
Number:	Number 6
Page Range:	pp. 865-870
DOI:	10.1093/icvts/ivt045
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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