Long-Term Sensory Function 3 Years after Minimally Invasive Repair of Pectus Excavatum with Cryoablation | 47 patients median age, 18.4 years | 2.9 years median bar dwell time | 2 median bars placed | Prospective Cohort | <21 years of age | Single site | Presented for bar removal | RESULTS | 80.9% secured with pericostal sutures | 46.8% chest wall hypoesthesia present | 13% neuropathic symptoms | Mean percentage of hypoesthesia: | 4.7 ± 9.3% (cold) | 3.9 ± 7.7% (soft touch) | 5.9 ± 11.8% (pinprick) | Conclusion: In pectus excavatum repair with cryoablation, chest wall hypoesthesia and neuropathic symptoms are common, however neuropathic pain is rare and did not require treatment | https://doi.org/10.1016/j.jpedsurg.2023.10.058 | SOURCE: Eldredge S et al. | Division of Pediatric Surgery, Phoenix Children's, Phoenix, AZ, USA | @StayCurrentMD | @kim_p_m | Cincinnati Children's | Journal of Pediatric Surgery
Long-Term Sensory Function 3 years after Minimally Invasive Repair of Pectus Excavatum with Cryoablation
Infographic · Jun 2024 · 1 min read
In brief
In brief
Prospective study of 47 patients shows that 3 years after minimally invasive pectus excavatum repair with intercostal nerve cryoablation, 47% experienced mild chest wall hypoesthesia affecting only 4-6% of treated surface area. Neuropathic symptoms occurred in 13% but required no treatment, supporting cryoablation as a safe adjunct for pain control.
- Cryoablation during MIRPE reduces hospital stay and opioid use while maintaining acceptable long-term sensory outcomes.
- At 3 years post-op, 47% of patients had detectable hypoesthesia affecting only 4-6% of treated chest wall surface area.
- Sensory changes were limited to 1-2 dermatomes in most cases, with T5 being the most commonly affected level.
- Chronic neuropathic pain was rare (13% reported symptoms) and none required treatment at long-term follow-up.
- Cryoablation appears to be a safe adjunct for pain control in pectus repair with minimal long-term sensory sequelae.
Written by the GCMD Library team from the infographic.
The infographic uses a teal and blue color scheme with yellow accent text. It features a calendar icon, a patient illustration, and a torso diagram highlighting the chest area. The layout is divided into sections with arrows pointing to key results, and includes institutional branding at the bottom.
New Infographic from the Journal of Pediatric Surgery by Kim Priban RN
"Long-Term Sensory Function 3 years after Minimally Invasive Repair of Pectus Excavatum with Cryoablation"
Authors: R Scott Eldredge, Brielle Ochoa, Emily Khoury, Kristin Mihalcin, Daniel Ostlie, Justin Lee, Lisa McMahon, David Notrica, Benjamin E. Padilla
Full article: https://gcmd.co/3wATBod
Introduction
Minimally invasive repair of pectus excavatum (MIRPE) with intercostal nerve cryoablation (Cryo) decreases length of hospitalization and opioid use, but long-term recovery of sensation has been poorly described. The purpose of this study was to quantify long-term hypoesthesia and neuropathic pain after MIRPE with Cryo.
Methods
A prospective cohort study was conducted single-institution of patients ≤21 years who presented for bar removal. Consented patients underwent chest wall sensory testing and completed neuropathic pain screening. Chest wall hypoesthesia to cold, soft touch, and pinprick were measured as the percent of the treated anterior chest wall surface area (TACWSA); neuropathic pain was evaluated by questionnaire.
Results
The study enrolled 47 patients; 87% male; median age 18.4 years. The median bar dwell time was 2.9 years. A median of 2 bars were placed; 80.9% were secured with pericostal sutures. At enrollment, 46.8% of patients had identifiable chest wall hypoesthesia. The mean percentage of TACWSA with hypoesthesia was 4.7 ± 9.3% (cold), 3.9 ± 7.7% (soft touch), and 5.9 ± 11.8% (pinprick). Hypoesthesia to cold was found in 0 dermatomes in 62%, 1 dermatome in 11%, 2 dermatomes in 17% and ≥3 dermatomes in 11%. T5 was the most common dermatome with hypoesthesia. Neuropathic symptoms were identified by 13% of patients; none required treatment.
Conclusions
In long-term follow up after MIRPE with Cryo, 46.8% of patients experienced some chest wall hypoesthesia; the average TACWSA with hypoesthesia was 4–6%. Hypoesthesia was mostly limited to 1–2 dermatomes, most commonly T5. Chronic symptomatic neuropathic pain was rare.