초록접수 현황
| 14F-236 | 구연 발표 |
The “Flare-buster” to Relieve Lower Costal Flare in Pectus Excavatum Repair: Flare Angle Measurements
김경수, 박형주, 문영규, 안효찬, 김도연, 현관용, 최국빈, 박재길, 성숙환
가톨릭대학교 의과대학 서울성모병원 흉부외과학교실
Background : Pectus excavatum repair using a pectus bar has been satisfactory but remaining lower costal flare was an unsolved problem. We introduced simple technique to compress flared ribs with a subcutaneously placed string. The purpose of this study is to demonstrate the effectiveness of the "Flare-buster" technique in relief of the lower costal flare.
Methods : From September 2011 to May 2014, Total 161 patients (116 males, 45 females) with a mean age of 6 years (range, 3-26 yrs) underwent "Flare-buster" technique. Briefly, the technique involves that a subcutaneously placed string (PDS No.2 double stranded) connected between both ends of the pectus bar that compresses the lower costal flare cartilages. To measure the degree of the flare protrusion, the flare angle, the angle between the chest wall line and the flare line at the most protruded costal flare lesion on the chest CT scan, was measured. The results were estimated as one of the three grades (Grade I: none to mild, less than 10°; Grade II: moderate, 10 - 20°; Grade III: marked, more than 20°). We compared the angles between “non-flare-buster” (N=20) group and “flare-buster” group (N=20).”
Results : There was no difference in age, sex and Grand canyon type, Haller index and depression index between two groups. Flare score was significantly different between two groups [Grade I: Grade 2: Grade 3= 1:17:2 vs 20:0:0, p<0.001)]. Flare score was checked as grade I in all 20 (100%) flare-buster applied patients. In conventional group, 17 (85 %) and 2 (10%) patients were graded as II and III, respectively. Flare angle in “flare-buster” group was significantly lower than in conventional group (16.51±3.89 vs 5.95±2.10, p<0.001) that the angle of flared rib in a “flare-buster” was closer to the normal level.
Conclusion : With these results, the flare-buster technique proved to be effective in compressing the lower costal flare. Lower costal flare has been cumbersome problem since the inception of Nuss repair of pectus excavatum, but this simple technique contributes to improve cosmetic outcomes.
Methods : From September 2011 to May 2014, Total 161 patients (116 males, 45 females) with a mean age of 6 years (range, 3-26 yrs) underwent "Flare-buster" technique. Briefly, the technique involves that a subcutaneously placed string (PDS No.2 double stranded) connected between both ends of the pectus bar that compresses the lower costal flare cartilages. To measure the degree of the flare protrusion, the flare angle, the angle between the chest wall line and the flare line at the most protruded costal flare lesion on the chest CT scan, was measured. The results were estimated as one of the three grades (Grade I: none to mild, less than 10°; Grade II: moderate, 10 - 20°; Grade III: marked, more than 20°). We compared the angles between “non-flare-buster” (N=20) group and “flare-buster” group (N=20).”
Results : There was no difference in age, sex and Grand canyon type, Haller index and depression index between two groups. Flare score was significantly different between two groups [Grade I: Grade 2: Grade 3= 1:17:2 vs 20:0:0, p<0.001)]. Flare score was checked as grade I in all 20 (100%) flare-buster applied patients. In conventional group, 17 (85 %) and 2 (10%) patients were graded as II and III, respectively. Flare angle in “flare-buster” group was significantly lower than in conventional group (16.51±3.89 vs 5.95±2.10, p<0.001) that the angle of flared rib in a “flare-buster” was closer to the normal level.
Conclusion : With these results, the flare-buster technique proved to be effective in compressing the lower costal flare. Lower costal flare has been cumbersome problem since the inception of Nuss repair of pectus excavatum, but this simple technique contributes to improve cosmetic outcomes.
책임저자: 박형주
가톨릭대학교 의과대학 서울성모병원 흉부외과학교실
연락처 : 김경수, Tel: 02-2258-6320 , E-mail : cskks@catholic.ac.kr
