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Ann Thorac Surg 1996;61:1625
© 1996 The Society of Thoracic Surgeons

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Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1618.

DR HAROLD C. URSCHEL, JR (Dallas, TX): This is a landmark paper and I think probably one of the most important on the program. There is virtually no literature about this disease, and I have never seen a case personally. I would be interested to poll the audience to see if anybody has seen a personal case. I have seen one referred to me for medical-legal reasons that was operated on before the age of 4 years in which this developed, and then subsequently another case that never healed and had a total flail chest with excessive use of the cautery. These cases represent the two ends of the spectrum.

This is like volume reduction in reverse. When I came to Texas 35 years ago, Shaw and Paulson had operated on many of the young kids with tracheoesophageal fistulas, pectuses, and so on. I found 38 cases that were operated on at age 4 years or younger, and there were no cases in which this complication subsequently developed. Doctor Haller sent me this manuscript to review.

The possible explanations are, as he pointed out, you either injure the rib or sternal growth centers someplace, wherever they are, or the resection of the perichondrium totally could fail to regenerate any perichondrium and the patient would heal by fibrous tissue that was solid not flail. I think that this is an excellent report and an excellent solution.

. . . [Full Text of this Article]

Related Article

Chest Wall Constriction After Too Extensive and Too Early Operations for Pectus Excavatum

J. Alex Haller, Jr, Paul M. Colombani, C. Thomas Humphries, Richard G. Azizkhan, and Gerald M. Loughlin
Ann. Thorac. Surg. 1996 61: 1618-1624. [Abstract] [Full Text]

This article has been cited by other articles:

				F. Robicsek and A. A. Fokin How not to do it: restrictive thoracic dystrophy after pectus excavatum repair Interactive CardioVascular and Thoracic Surgery, December 1, 2004; 3(4): 566 - 568. [Abstract] [Full Text] [PDF]