Pulmonary function in patients with congenital pectus excavatum

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Abstract

BACKGROUND: Pectus excavatum is the most common congenital chest wall deformity. To date, there is no consensus on whether this deformity interferes with normal lung growth.

AIM: This study work aimed to evaluate the effect of age at clinical onset of pectus excavatum on pulmonary function.

METHODS: A comparative analysis of pulmonary function was performed in 38 patients with pectus excavatum before thoracoplasty according to the Nuss procedure and before removal of the chest wall fixation bar. The inclusion criteria were congenital chest wall deformity, a Haller index greater than 3.25, a compression index less than 0.89, and age 9–15 years at the time of the Nuss procedure. The non-inclusion criteria were scoliosis greater than grade III, congenital heart defects, recurrence of chest wall deformity, verified genetic or systemic diseases, and refusal of the patient or legal representative to participate in the study. The patients were divided into two groups. Group 1 included all patients with pectus excavatum aged 9–11 years who underwent evaluation and surgery during the study. Group 2 included a stratified sample of 19 patients with the same deformity aged 12–15 years.

RESULTS: Before thoracoplasty, group 2 demonstrated lower vital capacity than group 1 (p = 0.037). The ratio of forced expiratory volume in 1 second to forced vital capacity was also lower in group 2 (p = 0.079), as was the mean forced expiratory flow between 25% and 75% of forced vital capacity (p = 0.027). No significant differences in pulmonary function parameters were identified between the two groups before removal of the chest wall fixation bar. Significant differences in pulmonary function parameters were also observed between measurements obtained before thoracoplasty and before chest wall fixation bar removal in both groups.

CONCLUSION: The identified statistically significant differences in pulmonary function parameters between age groups of patients with pectus excavatum before thoracoplasty suggest age-related deterioration of lung function in the absence of surgery. However, long-term prospective studies in patients from childhood through adolescence are required to confirm this assumption.

About the authors

Alina M. Khodorovskaya

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Author for correspondence.
Email: alinamyh@gmail.com
ORCID iD: 0000-0002-2772-6747
SPIN-code: 3348-8038

MD

Russian Federation, Saint Petersburg

Dmitry V. Ryzhikov

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: dryjikov@yahoo.com
ORCID iD: 0000-0002-7824-7412
SPIN-code: 7983-4270

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Bahauddin H. Dolgiev

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: dr-b@bk.ru
ORCID iD: 0000-0003-2184-5304
SPIN-code: 2348-4418

MD

Russian Federation, Saint Petersburg

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