Minimally invasive repair of pectus carinatum by the Abramson method: A systematic review of six studies
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In brief
In brief
Systematic review of 396 patients undergoing minimally invasive pectus carinatum repair via the Abramson method demonstrates high efficacy with 99.5% satisfactory initial results and 91% satisfaction after bar removal. Low recurrence rate (3%) and acceptable complication profile (26.5%) support this as a safe, effective treatment for chest wall deformity correction.
Written by the GCMD Library team from the article.
Background
: The aim of this review is to provide an overview of the outcomes after minimally invasive pectus cartinatum repair (MIRPC) by the Abramson method to determine its effectiveness.
Methods
: The PubMed and Embase databases were systematically searched. Data concerning subjective postoperative esthetic outcomes after initial surgery and bar removal were extracted together with data on recurrence, complications, operative times, blood loss, post-operative pain, length of hospital stay, planned time to bar removal and reasons for early bar removal. The postoperative esthetic result, was selected as primary outcome since the primary indication for repair in pectus carinatum is of cosmetic nature.
Results
: Six cohort studies were included based on eligibility criteria, enrolling a total of 396 patients. Qualitative synthesis showed excellent to satisfactory initial post-operative esthetic results in nearly all patients after correctional bar placement (99.5%, n=183/184). A high satisfaction rate of 91.0% (n=190/209) was found in patients after bar removal. Recurrence rates were low and occurred in 3.0% (n=5/168). The cumulative postoperative complication rate was 26.5% (n=105/396), of whom 25% required surgical re-intervention. There were no cases of mortality.
Conclusions
: Minimally invasive repair of pectus carinatum through the Abramson method is effective and safe. Its efficacy is demonstrated by the excellent to satisfactory esthetic results in 99.5% and 91.0% of patients after respectively correctional bar placement and implant removal. Future studies should aim to compare different treatment options for pectus carinatum in order to elucidate the approach of choice for different patient groups.