Pulmonary function before surgery for pectus excavatum and at long-term follow-up.

Pulmonary function tests were performed before surgery on 152 patients who were operated on for pectus excavatum between 1970 and 1987 and at long-term follow-up to assess the degree of impairment and to investigate any changes caused by surgical correction. The mean age at surgery was 15.3 +/- 5.5 years. Pulmonary function was found to be restricted preoperatively. Multivariate analysis showed that preoperative pulmonary function was not related to age, the severity of the deformity at physical examination, or to pulmonary complaints. Only the patients with obstructive disease showed significantly more pulmonary complaints (p = 0.042). The total lung capacity (TLC) and inspiratory vital capacity (IVC) were significantly related to the age-corrected (delta) anteroposterior diameter of the chest (lower vertebral index [LVI]) (p = 0.0001). At follow-up (mean, 8.1 +/- 3.6 years), the restriction of pulmonary function was increased despite improvement in the symptoms of most patients and despite a significant increase in the anteroposterior diameter of the chest (p = 0.0001): the TLC was decreased from 83.7 percent predicted (pred) preoperatively to 73.8 percent pred (p = 0.0001) and the IVC from 78.3 percent pred to 70.7 percent pred (p = 0.0001). The surgical results were satisfactory in 83.6 percent. No relation was found between the changes in pulmonary function measured at follow-up and the surgical results. Only the age at surgery and the changes in the TLC and IVC at follow-up were significantly related (p = 0.0036, 0.0043, respectively), although the correlation coefficients were low (r = 27 percent and 28 percent, respectively). The reduction in lung function at follow-up was most pronounced in the patients who had the least functional impairment (TLC > 75 percent pred) preoperatively. No correlation was found between the changes in the pulmonary function test results at follow-up and follow-up interval, preoperative delta LVI, and the change in delta LVI at follow-up.

[1]  A. Torres,et al.  Relevance of Chlamydia pneumoniae in community-acquired respiratory infections. , 1993, The European respiratory journal.

[2]  T. Ohnuki,et al.  Degree of severity of pectus excavatum and pulmonary function in preoperative and postoperative periods. , 1992, The Journal of thoracic and cardiovascular surgery.

[3]  H. Folgering,et al.  Pectus excavatum. A clinical study with long-term postoperative follow-up. , 1992, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[4]  D. Driscoll,et al.  Exercise cardiorespiratory function in adolescents with pectus excavatum. Observations before and after operation. , 1990, The Journal of thoracic and cardiovascular surgery.

[5]  F. Xue.  [On the surgical treatment of pectus excavatum]. , 1989, Zhonghua wai ke za zhi [Chinese journal of surgery].

[6]  M. Demedts,et al.  Preoperative and postoperative abnormalities in chest x-ray indices and in lung function in pectus deformities. , 1989, Chest.

[7]  M. Demedts,et al.  Mechanism of pulmonary function changes after surgical correction for funnel chest. , 1988, The European respiratory journal.

[8]  R. Shamberger,et al.  Cardiopulmonary function in pectus excavatum. , 1988, Surgery, gynecology & obstetrics.

[9]  R. Jones,et al.  Noninvasive assessment of exercise cardiac function before and after pectus excavatum repair. , 1985, The Journal of thoracic and cardiovascular surgery.

[10]  J. Cahill,et al.  A summary of preoperative and postoperative cardiorespiratory performance in patients undergoing pectus excavatum and carinatum repair. , 1984, Journal of pediatric surgery.

[11]  A. Eijgelaar,et al.  LUNG-FUNCTION CHANGES AFTER OPERATION FOR PECTUS EXCAVATUM AND PECTUS CARINATUM , 1984 .

[12]  Standardized lung function testing. Report working party. , 1983, Bulletin europeen de physiopathologie respiratoire.

[13]  R. Castile,et al.  Symptomatic pectus deformities of the chest. , 1982, The American review of respiratory disease.

[14]  A. Jaretzki,et al.  Pectus excavatum. Late results with and without operation. , 1980, The Journal of thoracic and cardiovascular surgery.

[15]  P. Majid,et al.  Pectus excavatum and cardiac dysfunction: a case report with pre- and post-operative haemodynamic studies. , 1979, Thorax.

[16]  M. Ravitch.  Congenital deformities of the chest wall and their operative correction , 1977 .

[17]  K. Ashcraft.  Technical considerations in the surgical management of pectus excavatum and carinatum , 1975 .

[18]  Gattiker Hf.  Effect of funnel chest on cardiac function. , 1973 .

[19]  H. Gattiker.  Effect of funnel chest on cardiac function. , 1973, The New England journal of medicine.

[20]  M. Stampfer,et al.  Impairment of cardiac function in patients with pectus excavatum, with improvement after operative correction. , 1972, The New England journal of medicine.

[21]  R. Cook.  The etiology and pathogenesis of funnel chest : H. Geisbe, H. Mildenberger, A Flack, and H. Fendel. Progr. Pediat. Surg. 3:13–36, 1971 , 1972 .

[22]  S. Tůma,et al.  Assessment of airway function in children. , 1972, Bulletin de physio-pathologie respiratoire.

[23]  H. Fendel,et al.  The aetiology and pathogenesis of funnel chest. , 1971, Progress in pediatric surgery.

[24]  J. G. Weg,et al.  Pulmonary dysfunction in pectus excavatum. , 1967, The American review of respiratory disease.

[25]  G. Polgar,et al.  PULMONARY FUNCTION IN PECTUS EXCAVATUM. , 1963, Pediatrics.

[26]  F. Robicsek,et al.  CONGENITAL DEFORMITIES OF THE ANTERIOR CHEST WALL SURGICAL MANAGEMENT AND OPERATIVE RESULTS. , 1963, Collected works on cardio-pulmonary disease.

[27]  S. Bevegård.  Postural circulatory changes at rest and during exercise in patients with funnel chest, with special reference to factors affecting the stroke volume. , 2009, Acta medica Scandinavica.

[28]  J. Murray,et al.  Pectus excavatum. An analysis of twenty-seven cases. , 1961, Archives of internal medicine.

[29]  O G BACKER,et al.  Radiologic evaluation of funnel chest. , 1961, Acta radiologica.

[30]  R. Daniel.  The surgical treatment of pectus excavatum. , 1958, The Journal of thoracic surgery.

[31]  E. Chin.  Surgery of funnel chest and congenital sternal prominence , 1957, The British journal of surgery.

[32]  J. L. Hansen,et al.  The respiratory function before and following surgery in cases of funnel chest. , 1956, Acta chirurgica Scandinavica.

[33]  H. Lyons,et al.  VENTILATOHY AND LUNG VOLUME DETERMINATIONS IN PATIENTS WITH CHEST DEFORMITIES , 1956, The American journal of the medical sciences.

[34]  H. Brodkin,et al.  Congenital chondrosternal depression (funnel chest) relieved by chondrosternoplasty. , 1948, American journal of surgery.