Current concepts and challenges in the surgical correction of pectus excavatum in children
https://doi.org/10.52888/0514-2515-2025-366-3-96-102
Abstract
The article provides a literature review of the etiological aspects of congenital chest deformities, the characteristics of various sternal curvatures, and the manifestations of decreased thoracic vertebral distance and diaphragm excursions in children. It provides clinical data on restrictive respiratory dysfunction with decreased tidal volume, as well as cardiac dysfunction. The article thoroughly describes the surgical treatment principles for children with congenital chest deformities, depending on the degree of deformation and the patient’s condition severity. Conservative treatment methods, such as vacuum therapy and vacuum bell use, are also covered. Despite the wide range of surgical interventions, the D. Nussa operation with modifications is the most suitable method for correcting congenital chest deformities in children.
About the Authors
S. B. Davlyatov
SEI Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Tajikistan
Competing Interests:
Tajikistan
Davlyatov Sayfullo Boboevich - Doctor of Medical Sciences, Professor of the Department of Pediatric Surgery
Dushanbe
Competing Interests:
authors declare no conflict of interest
Kh. I. Ibodov
SEI Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Tajikistan
Competing Interests:
Tajikistan
Ibodov Khabibullo - Doctor of Medical Sciences, Professor of the Department of Pediatric Surgery
Dushanbe
Competing Interests:
authors declare no conflict of interest
R. R. Rofiev
SEI Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Tajikistan
Competing Interests:
Tajikistan
Rofiev Rauf Rofievich - PhD, professor. Professor of the Department of Pediatric Surgery and Anesthesiology
Dushanbe, Tel.: +992918218950
Competing Interests:
authors declare no conflict of interest
S. Ch. Sulaymonov
SEI Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Tajikistan
Competing Interests:
Tajikistan
Sulaymonov Sadriddin Chinpulatovich - applicant of the Department of Pediatric Surgery
Dushanbe
Competing Interests:
authors declare no conflict of interest
References
1. Bairov G.A. Operations for congenital funnel chest deformity. In the book: Children’s operative surgery. Ed. by V.D. Tikhomirova. - M: OOO “Medical Information Agency. 2011;27234:1960.
2. Bochkarev V.S., Bochkareva I.V. New method of correction of funnel chest deformity. News of higher educational institutions. Volga region. Medical sciences. 2014;(1):46−53.
3. Gatsutsyn V.V., Nalivkin G.E., Kuzmichev V.A., et al. Rationale for a differentiated approach to diagnostics and surgical correction of funnel chest deformity in children. Pediatric surgery. 2018;22(4):199−204
4. Gileva V.A., Tyukhai D.A. Radiation methods in assessing the degree of funnel chest deformity (literature review). Young scientist. 2017;(4):249−253.
5. Gorelkin I.V., Pogosyan K.L., Lukyanenko E.A. Correlation of the degree of funnel chest deformity with the severity of connective tissue dysplasia in children. Saratov Scientific Medical Journal. 2012;8(3):842–845.
6. Davlyatov S.B., Mukhiddinov N.D. Correction of funnel chest deformity in children. Health, demography, ecology of the Finno-Ugric peoples. 2016;(3):85−87.
7. Dalyatov S.B., Ibodzoda H.I., Rofiev R.R. Optimization of surgical correction of funnel-shaped deformity in children. Avicenna Bulletin. 2018; (21):306-307.
8. Dalyatov S.B., Sulaimonov S.Ch., Rofiev R.R. Results of congenital correction of funnel-shaped deformity in children. Journal of Postgraduate Education Bulletin in Healthcare. 2023; (2):26-30.
9. Kamolkin I.A., Agranovich O.E., Clinical variants of chest deformity. Journal of Clinical and Experimental Orthopedics named after G.A. Ilizarov. 2017;(2):241- 247.
10. Korolev P.A., Kozhevnikov O.V., Rudakov S.S., et al. Results of radical thoracoplasty from small approaches with fixation of the sternocostal complex with a metal plate with a shape memory effect in case of funnel-shaped chest deformity. Journal of the Bulletin of Traumatology and Orthopedics named after N.N.Pirogov. 2015;(4):5-9
11. Mirzokarimov B.Kh., Dzhumaboev Zh.U., Karimov D.K. Modern treatment of the surgical problem of chest deformity in children. J Biomedicine and Practice 2021; (2): 44-49.
12. Mishina T.P., Isalabdulaeva P.A., Makhachev S.M., et al. Evaluation of cardiorespiratory function before and after surgical correction of funnel chest deformity in children. Pediatric surgery. 2013;(3):33−37.
13. Motorenko N.V., Vinnik A.V. Funnel chest deformity in children. Health and ecology issues. 2022;19(1):47-54.
14. Motorenko N.V. The state of the external respiratory function in children with VDK. Zh. Functional Science in Modern Medicine. 2023;20(4):91-95.
15. Nekrasova E.G. The importance of age limit for thoracoplasty in children with funnel-shaped chest deformity. In the collection of scientific papers dedicated to the 100th anniversary of medical education in the Perm region, the 95th anniversary of the birth of Professor A.A. Lishke “New technologies in pediatric surgery”. Perm. 2014;146-152.
16. Pechetov A.A., Esakov Yu.S., Gubaidullina G.F., et al. Choice of method for correction of funnel chest deformity in elderly patients. Surgery. Journal im. N.I. Pirogov. 2017;(7):24−29.
17. Razumovsky A.Yu., Alkhasov A.B., Mitupov Z.B., et al. Comparative evaluation of treatment results with different methods of thoracoplasty in children with funnel chest deformity. Russian Bulletin of Pediatric Surgery, Anesthesiology and Resuscitation. 2017;7(2):7−12.
18. Razumovsky A.Yu., Alkhasov A.B., Mitupov Z.B., et al. 15-year experience in treating funnel chest deformity in children. Pediatric surgery. 2016;20(6):284−287.
19. Razumovsky A.Yu., Alkhasov A.B., Mitupov Z.B., et al. Analysis of perioperative complications in the correction of funnel chest deformity using the modified Nass technique. Pediatric surgery. 2017;21(5):251−257.
20. Ruzikulov U.Sh. Clinical manifestations of funnel chest deformity in children of different ages. Journal of Theoretical and Clinical Medicine. 2014;(2):110−112.
21. Ruzikulov U.Sh. Surgical treatment of congenital funnel chest deformity using D. Nuss method. Scientific discussion: issues of medicine.2017;(1):62−68.
22. Stalmakhovich V.N., Dyukov A.A., Dmitrienko A.P., Dudenkov V.V. Rare complications after thoracoplasty in children with congenital funnel chest deformity. Bulletin of the East Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences. 2015(3):18−20.
23. Stalmakhovich V.N., Dudenkov V.V., Dyukov A.A. Treatment of funnel chest deformity in children. Pediatric Orthopedics, Traumatology and Reconstructive Surgery. 2017;5(3):17−24.
24. Khozhan I.Yu., Khakimov Sh.K., Kasymov Kh.A., Shamatov Kh.Sh. Issues of diagnostics and treatment of funnel chest deformity in children. Annals of plastic, reconstructive and aesthetic surgery. 2015;(1):40−46.
25. Khozhan I.Yu., Khakimov Sh.K., Kasymov H.A. Selection of the method of surgical treatment of funnel chest deformity in children based on the criteria of elasticity of the sternocostal complex. Traumatology and Orthopedics of Russia. 2013;(3):130−135.
26. Anatomical, histologic, and genetic characteristics of congenital chest wall deformities / A.A. Fokin, N.M. Steuerwald, W.A. Ahrens, K.E. Allen // Semin.Thorac. Cardiovasc. Surg. 2009. Vol. 21, no. 1. P. 44-57. doi: 10.1053/j.semtcvs.2009.03.001
27. Brian G.A., Millspaugh D.L., Desai A.A., et al. Pectus excavatum: Benefit of randomization. J Pediatric Surg. 2015;50(Issue 11):1937–1939.
28. Digtyar V.A., Kaminska M.O., Moxov A.I., Koval S.V. Experience of surgical treatment of pectus excavatum in children. Surgery for children. 2018;(1):81−84.
29. Engum S., Rescorla F., West K., et al. Is the grass greener? Early results of the Nuss procedure. J. Pediatr. Surg. 2020; 35(2):246−251.
30. Fronts F.W. Inducations and guidelines for pectuc excavatium repair. Curr. Opin. Pediatr.2011:23:486-491.
31. Nuss D. Minimallu invasive surgical of pectus excavatum. Semin. Pediatr. Surg.2008.17.2009-2017.
32. Paulson R.J., Cohen N.S., Kelly R.E., Jr, etae. Nonoperative management at pectus excavatum with racum bell therapy; A single center study obeimeyer. J. Pediatr. Surg. 2018; 53 (Isse 6): 1221-1225.
33. Rhee D.S., Boss E., Alaish S.M., Oswald A.V. Tetteh Minimally invasive repair of pectusexcavatum: Analysis of the NSQIP database and the use of thoracoscopy. Garcia J Pediatr. Surg.2018;53 (Issue 6):1230–1233.
34. Sesia S.B., Hradetzky D., Haecker F.-M. Monitoring the effectiveness of the vacuum bell during pectus excavatum treatment: Technical innovation. J. Pediatr. Surg. 2017;53(Issue3):411–417.
35. Sigalet D.L. Montgomery M, Harder J, Wond K, Kravarisic D/, Allasiri A. Long term cardiopulmonary effects of closed repair of pectus axcavatum. Pediatr. Sury. Int 2007.23(5)193-407.
Review
For citations:
Davlyatov S.B., Ibodov Kh.I., Rofiev R.R., Sulaymonov S.Ch. Current concepts and challenges in the surgical correction of pectus excavatum in children. Health care of Tajikistan. 2025;(3):96-102. (In Russ.) https://doi.org/10.52888/0514-2515-2025-366-3-96-102
Views:
19
Email this article 