title: Simplified open repair for anterior chest wall deformities. Analysis of results in 205 patients.
abstract: BACKGROUND
  Pectus deformities are the most frequently seen congenital thoracic wall anomalies. The cause of these conditions is thought to be abnormal elongation of the rib cartilages. We here report our clinical experience and the results of a sternochondroplasty procedure based on the subperichondrial resection of the elongated cartilages.
  
  
  OBJECTIVE
  This technique is a valuable surgical strategy to treat the wide variety of pectus deformities.
  
  
  METHODS
  During the period from October 2001 through September 2009, 205 adult patients (171 men and 34 women) underwent pectus excavatum (181), carinatum (19) or arcuatum (5) repair. The patients' pre and postoperative data were collected using a computerized database, and the results were assessed with a minimum 2-year follow-up.
  
  
  RESULTS
  The postoperative morbidity rate was minimal and the mortality was nil. The surgeon graded cosmetic results as excellent (72.5%), good (25%) or fair (2.5%), while patients reported better results. Patients with pectus excavatum were found to have much more patent foramen ovale (PFO) than the normal adult population, which occluded after the procedure in 61% of patients, and significant improvement was found in exercise cardiopulmonary function and exercise tolerance at the 1-year follow-up.
  
  
  CONCLUSIONS
  Our sternochondroplasty technique based on the subperichondrial resection of the elongated cartilages allows satisfactory repair of both pectus excavatum and sternal prominence. It is a safe procedure that might improve the effectiveness of surgical therapy in patients with pectus deformities.
authors.affiliation: Thoracic and Cardiac Surgery Division, Albert Calmette Hospital, Lille University Teaching Hospital, 59037 Lille cedex, France. alain.wurtz@chru-lille.fr
authors.forename: A
authors.initials: A
authors.lastname: Wurtz
authors.forename: N
authors.initials: N
authors.lastname: Rousse
authors.forename: L
authors.initials: L
authors.lastname: Benhamed
authors.forename: M
authors.initials: M
authors.lastname: Conti
authors.forename: I
authors.initials: I
authors.lastname: Hysi
authors.forename: C
authors.initials: C
authors.lastname: Pinçon
authors.forename: R
authors.initials: R
authors.lastname: Nevière
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012272:Ribs / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D013249:Sternum / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D035441:Thoracic Wall / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D013905:Thoracoplasty / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult