Minimal cosmetic revision required after minimally invasive pectus repair

• Published in: Pediatric surgery international Vol. 34; no. 7; pp. 775 - 780
• Main Authors: Murphy, Brittany L., Naik, Nimesh D., Roskos, Penny L., Glasgow, Amy E., Moir, Christopher R., Habermann, Elizabeth B., Klinkner, Denise B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2018; Springer Nature B.V
• Subjects: Adolescent; Child; Child, Preschool; Female; Funnel Chest - surgery; Humans; Infant; Infant, Newborn; Male; Medicine; Medicine & Public Health; Original Article; Patient Care Team; Pectus Carinatum - surgery; Pediatric Surgery; Pediatrics; Reconstructive Surgical Procedures; Referral and Consultation; Retrospective Studies; Scoliosis; Scoliosis - complications; Surgery; Young Adult; Plastic surgery; Pectus deformity; Residual deformity; Multidisciplinary
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-018-4275-8

Background Despite surgical correction procedures for pectus deformities, remaining cosmetic asymmetry may have significant psychological effects. We sought to evaluate factors associated with plastic surgery (PS) consultation and procedures for these deformities at an academic institution. Methods We reviewed patients aged 0–21 diagnosed with a pectus excavatum or carinatum deformity at our institution between January 2001 and October 2016. Pectus diagnoses were identified by ICD-9/ICD-10 codes and surgical repair by CPT codes; patients receiving PS consultation were identified by clinical note service codes. Student’s t tests, Fisher’s exact tests, and Chi-squared tests were utilized. Results 2158 patients were diagnosed with a pectus deformity; 442 (20.4%) underwent surgical correction. 19/442 (4.3%) sought PS consultation, either for pectus excavatum [14/19 (73.7%)], carinatum [4/19 (21.0%)], and both [1/19 (5.3%)], ( p  = 0.02). Patients seeking PS consultation were more likely to be female ( p  < 0.01), have scoliosis ( p  = 0.02), or undergo an open repair ( p  < 0.01). The need for PS consultation did not correlate with Haller index, p  = 0.78. Conclusion PS consultation associated with pectus deformity repair was rare, occurring in < 5% of patients undergoing repair. Patients who consulted PS more commonly included females, patients with scoliosis, and those undergoing open repair. These patients would likely benefit most from multidisciplinary pre-operative discussions regarding repair of the global deformity.