Download PDF
Eur J Pediatr Surg 2021; 31(03): 261-265
DOI: 10.1055/s-0040-1712182
Original Article

Trends in the Treatment of Pectus Excavatum in the Netherlands

Wietse P. Zuidema
1   Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
,
Alida F. W. van der Steeg
2   Department of Pediatric Surgery, Princess Maxima Center, Utrecht, The Netherlands
,
Jan W. A. Oosterhuis
3   Department of Thoracic Surgery, Medical Centre Haaglanden, Den Haag, The Netherlands
,
Ernest van Heurn
4   Department of Pediatric Surgery, AMC/VUMC, Amsterdam, The Netherlands
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Introduction Pectus excavatum (PE) is the most common deformity of the anterior chest wall and can be corrected surgically with different techniques. In the past years, medical literature suggests that the minimal invasive surgical correction of PE (MIRPE) has currently become the operation technique of choice in Europe, and the number of PE patients undergoing surgery has increased. The aim of this study was to evaluate trends in the number of patients operated on and the surgical techniques generally used in patients with PE in the Netherlands.

Materials and Methods From the registration by Statistics Netherlands, the numbers of live births and gender were obtained for the period 1980 to 2017. Furthermore, from the Dutch hospital registration performed by Kiwa Prismant systems, the number of total surgical procedures of PE patients from the period 1998 to 2017, and the numbers of open and MIRPE surgery were obtained over the period 2005 to 2013.

Results The birth rate in Netherlands has stayed more or less stable in the last two decades. The number of PE patients asking for correction, however, has increased. In addition, the percentage of thoracoscopic assisted correction has increased.

Conclusion The increase in correction of PE is not due to an increased incidence but to an increase of patient wishes. The use of MIRPE is gaining popularity over time.

Keywords

pectus excavatum - surgery - pediatric - chest wall - minimally invasive repair of pectus excavatum


Publication History

Received: 06 July 2019

Accepted: 16 April 2020

Article published online:
26 May 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Cobben JM, Oostra RJ, van Dijk FS. Pectus excavatum and carinatum. Eur J Med Genet 2014; 57 (08) 414-417
    CrossrefPubMedGoogle Scholar
  • 2 Zuidema WP, Oosterhuis JWA, Zijp GW, van der Heide SM, van der Steeg AFW, van Heurn LWE. Early consequences of pectus excavatum surgery on self-esteem and general quality of life. World J Surg 2018; 42 (08) 2502-2506
    CrossrefPubMedGoogle Scholar
  • 3 Jaroszewski DE, Velazco CS, Pulivarthi VSKK, Arsanjani R, Obermeyer RJ. Cardiopulmonary function in thoracic wall deformities: what do we really know?. Eur J Pediatr Surg 2018; 28 (04) 327-346
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Jayaramakrishnan K, Wotton R, Bradley A, Naidu B. Does repair of pectus excavatum improve cardiopulmonary function?. Interact Cardiovasc Thorac Surg 2013; 16 (06) 865-870
    CrossrefPubMedGoogle Scholar
  • 5 Acosta J, Bradley A, Raja V. et al. Exercise improvement after pectus excavatum repair is not related to chest wall function. Eur J Cardiothorac Surg 2014; 45 (03) 544-548
    CrossrefPubMedGoogle Scholar
  • 6 Chavoin JP, Grolleau JL, Moreno B. et al. Correction of pectus excavatum by custom-made silicone implants: contribution of computer-aided design reconstruction. a 20-year experience and 401 cases. Plast Reconstr Surg 2016; 137 (05) 860e-871e
    CrossrefPubMedGoogle Scholar
  • 7 Patel AJ, Hunt I. Is vacuum bell therapy effective in the correction of pectus excavatum?. Interact Cardiovasc Thorac Surg 2019; 28: ivz082
    PubMedGoogle Scholar
  • 8 Lam MWC, Klassen AF, Montgomery CJ, LeBlanc JG, Skarsgard ED. Quality-of-life outcomes after surgical correction of pectus excavatum: a comparison of the Ravitch and Nuss procedures. J Pediatr Surg 2008; 43 (05) 819-825
    CrossrefPubMedGoogle Scholar
  • 9 Ravitch MM. The operative treatment of pectus excavatum. Ann Surg 1949; 129 (04) 429-444
    CrossrefPubMedGoogle Scholar
  • 10 Aronson DC, Bosgraaf RP, van der Horst C, Ekkelkamp S. Nuss procedure: pediatric surgical solution for adults with pectus excavatum. World J Surg 2007; 31 (01) 26-29
    CrossrefPubMedGoogle Scholar
  • 11 Hebra A, Kelly RE, Ferro MM, Yüksel M, Campos JRM, Nuss D. Life-threatening complications and mortality of minimally invasive pectus surgery. J Pediatr Surg 2018; 53 (04) 728-732
    CrossrefPubMedGoogle Scholar
  • 12 Patrick H, Gallaugher S, Czoski-Murray C. et al. Usefulness of a short-term register for health technology assessment where the evidence base is poor. Int J Technol Assess Health Care 2010; 26 (01) 95-101
    CrossrefPubMedGoogle Scholar
  • 13 Brochhausen C, Turial S, Müller FK. et al. Pectus excavatum: history, hypotheses and treatment options. Interact Cardiovasc Thorac Surg 2012; 14 (06) 801-806
    CrossrefPubMedGoogle Scholar
  • 14 Decates T, de Wijs L, Nijsten T, Velthuis P. Numbers on injectable treatments in the Netherlands in 2016. J Eur Acad Dermatol Venereol 2018; 32 (08) e328-e330
    CrossrefPubMedGoogle Scholar