# Long-Term Sensory Function 3 years after Minimally Invasive Repair of Pectus Excavatum with Cryoablation — GCMD Library

<p>New article you should know about by Kim Priban RN, selected by @‌jpedsurg</p>

<p>Made possible by @‌cincychildrens</p>

<p>"Long-Term Sensory Function 3 years after Minimally Invasive Repair of Pectus Excavatum with Cryoablation"</p>

<p>Authors: <em><a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">R Scott Eldredge</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">Brielle Ochoa</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">Emily Khoury</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">Kristin Mihalcin</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">Daniel Ostlie</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">Justin Lee</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">Lisa McMahon</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">David Notrica</a>, <a href="https://www.jpedsurg.org/article/S0022-3468(23)00668-1/abstract#">Benjamin E. Padilla</a></em></p>

<p>Full article:<a href="https://www.jpedsurg.org/article/S0022-3468(24)00074-5/abstract"> </a><a href="https://gcmd.co/3wATBod" target="_blank">https://gcmd.co/3wATBod</a></p>

<p><strong>Introduction</strong></p>

<p>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.</p>

<p><strong>Methods</strong></p>

<p>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.</p>

<p><strong>Results</strong></p>

<p>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.</p>

<p><strong>Conclusions</strong></p>

<p>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.</p>


Type: video · 1 min · posted 2024-06-13
Canonical: https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729

## Chapters
- [0:00](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=0) Introduction and Context
- [0:17](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=17) Study Design and Methods
- [0:44](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=44) Results and Conclusions

## Statements
- "Repair of pectus excavatum using minimally invasive techniques with intercostal nerve cryoablation decreases patient length of stay and opioid use" — Kim Priven (clinical) [0:00](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=0)
- "This was a single institution prospective cohort study of 47 patients under 21 years of age" — Kim Priven (clinical) [0:19](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=19)
- "Patients presented for bar removal after a median of two bars were placed for 2.9 years" — Kim Priven (clinical) [0:19](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=19)
- "The study assessed patients for chest wall hypoesthesia to cold, soft touch, and pinprick, as well as neuropathic pain" — Kim Priven (clinical) [0:35](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=35)
- "46.8% of patients had identifiable chest wall hypoesthesia" — Kim Priven (clinical) [0:46](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=46)
- "9.3% of patients had hypoesthesia to cold response" — Kim Priven (clinical) [0:46](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=46)
- "7.7% of patients had hypoesthesia to soft touch" — Kim Priven (clinical) [0:46](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=46)
- "11.8% of patients had hypoesthesia to pinprick" — Kim Priven (clinical) [0:46](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=46)
- "Neuropathic pain symptoms were identified in 13% of patients" — Kim Priven (clinical) [0:58](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=58)
- "None of the patients with neuropathic pain symptoms required treatment" — Kim Priven (clinical) [0:58](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=58)
- "Pediatric patients who underwent minimally invasive repair with cryoablation will often develop some small areas of hypoesthesia" — Kim Priven (clinical) [1:04](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=64)
- "Clinically significant neuropathic pain is rare after minimally invasive pectus excavatum repair with cryoablation" — Kim Priven (clinical) [1:04](https://library.globalcastmd.com/watch/long-term-sensory-function-3-years-after-minimally-invasive-repair-of-pectus-excavatum-with-cryoablation-8729?t=64)

## Transcript
Studies have shown that the repair of pectus excavatum using minimally invasive techniques with intercostal nerve cryoablation decreases patient length of stay and opioid use, but are there long-term side effects of the cryoablation? Hi, this is Kim Priven, a research fellow at Cincinnati Children's, and we think this is. Article worth knowing about. This was a single institution prospective cohort study of 47 patients under 21 years of age who presented for a bar removal after a median of two bars were placed for 2.9 years. The purpose of this study was to better understand if there's long-term hypoesthesia and neuropathic pain. The patients were assessed for chest wall hypoesthesia to cold, soft touch, and pinprick, as well as assessed for neuropathic pain. The results may surprise you. 46.8% of patients had identifiable chest wall hypoesthesia, with 9.3% to a cold response, 7.7% of patients to soft touch, and 11.8% of patients. To pinprick. Neuropathic pain symptoms were also identified in 13% of the patients, however, none of them required treatment. In conclusion, pediatric patients who underwent the minimally invasive repair with cryo will often develop some small areas of hypoesthesia, but clinically significant neuropathic pain is rare. Thank you for watching, like and share, and check back often for more articles we think you should know about.

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Not medical advice · citation policy: https://library.globalcastmd.com/ai