A case series: xiphoidectomy for xiphodynia, a rare thoracic wall disorder.

Autor:	Bakens MJAM; Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands., Andel PCM; Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands., Daemen JHT; Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands.; Faculty of Health, Medicine and Life Sciences (FHML), School for Oncology and Developmental Biology (GROW), Maastricht, The Netherlands., Hulsewé KWE; Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands., Vissers YLJ; Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands., de Loos ER; Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2021 Apr; Vol. 13 (4), pp. 2216-2223.
DOI:	10.21037/jtd-20-3396
Abstrakt:	Background: Xiphodynia is a rare musculoskeletal disorder characterized by pain at the lower anterior chest or epigastric region. Treatment options include oral analgesics, local injection with analgesic or laser therapy. Yet, these often provide only short-term symptom relieve. A definite reduction in pain sensation might be achieved by performing a xiphoidectomy, though studies on its safety and efficacy are scarce. In the current single-centre study the outcomes of xiphoidectomy for xiphodynia are retrospectively assessed. Methods: All patients undergoing xiphoidectomy for xiphodynia between April 2013 and February 2020 at Zuyderland Medical Centre, Heerlen, the Netherlands, were included in this case series. Pain scores using the Numeric Rating Scale were assessed preoperatively and postoperatively and submitted to the Wilcoxon signed rank test. A clinically significant improvement was defined as a 2-point decrease in Numeric Rating Scale score. In addition, surgical outcomes, including complications and duration of surgery were extracted from the patient records. Results: A total of 19 patients underwent xiphoidectomy for xiphodynia. The follow-up ranged from 1 to 83 months. Seventeen out of 19 patients showed a clinically relevant improvement in Numeric Rating Scale pain scores where the overall pain scores also revealed a statistically significant decrease from 8 (interquartile range, 7-8) to 0 (interquartile range, 0-0; P<0.001) after surgery. Median procedure time was 29 minutes (interquartile range, 24-38 minutes) and no postoperative complications occurred. Conclusions: Xiphoidectomy for xiphodynia is a safe and effective surgical procedure with good outcomes on pain relief. Though, future comparative studies are urged to elucidate its value among other treatment options. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-3396). The authors have no conflicts of interest to declare. (2021 Journal of Thoracic Disease. All rights reserved.)
Databáze:	MEDLINE
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