Skoczyński S, Kudela G, Brożek G, Lawson J, Tobor S, Skoczyńska A, Swinarew A, Trejnowska E, Winnicki IR, Repetowska K, Paluch J, Barczyk A, Koszutski T. Pulmonary function, exercise capacity and dyspnea in patients 7 years after Nuss surgery.
Adv Med Sci 2022;
67:179-186. [PMID:
35306355 DOI:
10.1016/j.advms.2022.02.008]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/23/2022] [Accepted: 02/28/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE
Pectus excavatum is a frequent thoracic malformation increasingly treated with minimally invasive methods (MIRPE), which are performed for cardio-respiratory problems and in some centers also for esthetic considerations. Theoretically, MIRPE may increase thoracic elastic recoil, work of breathing and cause emphysema. The aim of the present study was to determine whether teenagers who underwent MIRPE may expect normal thoracic cage development, cardio-respiratory function, exercise capacity and asymptomatic functioning.
MATERIAL AND METHODS
Fifty five patients (21.1 ± 3.0 years) who underwent MIRPE between 2000 and 2010 were assessed 6.8 (±2.4) years after surgery. Controls were matched for sex, age and height to the intervention participants. Spirometry, body plethysmography, diffusion capacity and the 6 min walking test (6MWT) were performed. Anteroposterior (AP) and transverse chest diameters were measured.
RESULTS
Participants who underwent MIRPE had normal pulmonary function, and exercise capacity. After adjustment for potential confounders, the intervention group had lower mean BMI [-1.88 ± 0.56 (kg/m2); p = 0.001] and chest AP diameter [-2.79 ± 0.57 (cm); p < 0.001], but higher residual volume (RV%) [12.98 ± 5.31 (%); p = 0.001], RV% total lung capacity (TLC) [5.56 ± 0.92 (%); p < 0.001], forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) [2.64 ± 1.28 (%); p = 0.039] and 6MWT distance [29.10 ± 13.02 (m); p = 0.025].
CONCLUSIONS
Young adults who undergo MIRPE may expect normal pulmonary function and exercise capacity. Observed differences in air trapping require further assessment in terms of emphysema development risk.
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