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Tedde ML, De Carvalho RLC, Milanez De Campos JR, Gomes Da Silva DA, Okumura EM, Falavigna GG, Marchesi AC, Petrizzo P, Souto Maior BS, Pego-Fernandes PM. Randomized comparison of oblique and perpendicular stabilizers for minimally invasive repair of pectus excavatum. Interdiscip Cardiovasc Thorac Surg 2024:ivae040. [PMID: 38492558 DOI: 10.1093/icvts/ivae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/22/2024] [Accepted: 03/14/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Bar dislocation is one of the most feared complications of the minimally invasive repair of pectus excavatum (MIRPE). METHODS Prospective randomized parallel-group clinical trial intending to assess whether oblique stabilizers can reduce bar displacement in comparison with regular stabilizers used in MIRPE. Additionally, we evaluated pain, quality of life (QoL) and other postoperative complications. Participants were randomly assigned to surgery with perpendicular (n = 16) or oblique stabilizers (n = 14) between October 2017 and September 2018 and followed for three years. Bar displacements were evaluated with the bar displacement index (BDI). Pain scores were evaluated through visual analogue scale and QoL through the Pectus Excavatum Evaluation Questionnaire. RESULTS Control group average BDI was 17.7 (±26.7) and intervention group average BDI was 8.2 (±10.9). There was one reoperation in each group which required correction with two bars. Bar displacement was similar among groups (p = 0.12). No other complications were recorded. There was no statistically significant difference on pain score. There was a significant difference between pre and post-operative composite scores of the participants' body image domain and psycho-social aspects in both groups. The difference between the pre and postoperative participants' perception of physical difficulties was greater and statistically significant in the intervention group. CONCLUSIONS There was no statistical difference in the use of perpendicular or oblique stabilizers, but the availability of different models of stabilizers during the study suggested that this can be advantageous. The trial is registered at ClinicalTrials.gov, number NCT03087734.
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Affiliation(s)
- Miguel L Tedde
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
- Hospital Infantil Sabará, Thoracic Surgery, -São Paulo, Brazil
| | - Rafael Lucas Costa De Carvalho
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Jose Ribas Milanez De Campos
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Diego Arley Gomes Da Silva
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Erica Mie Okumura
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Gustavo Guilherme Falavigna
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Alana Cozzer Marchesi
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Paulla Petrizzo
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Barbara Siqueira Souto Maior
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
| | - Paulo Manuel Pego-Fernandes
- Heart Institute (InCor), Hospital das Clínicas, University of Sao Paulo Medical School, Thoracic Surgery, -São Paulo, Brazil
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