Correction of a postpneumonectomy syndrome with congenital pectus excavatum using Ravitch’s procedure and silicone breast implants. Report of a case
| Autor: | Weam Essaleh, Franz Stanzel, Stefan Welter |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Stridor medicine.medical_treatment Article Breast implants 03 medical and health sciences chemistry.chemical_compound Pneumonectomy 0302 clinical medicine Silicone Pectus excavatum Bronchoscopy Case report medicine Deformity Postpneumonectomy syndrome medicine.diagnostic_test business.industry medicine.disease Surgery Stenosis chemistry 030220 oncology & carcinogenesis Right Main Bronchus 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • This paper demonstrates the repair of a severe left sided postpneumonectomy syndrome (PPS), aggravated by a pectus excavatum deformity. • The formation of this kind of pathology is very uncommon and therefore this case might be interesting for the readers. • We present the successful simultaneous repair of both pathologies. • The highlight of this case is the complete documentation of preoperative pathology, intraoperative findings and the postoperative outcome. Introduction Mediastinal repositioning and the use of allogenic implants to obliterate the postpneumonectomy space is the main principle of postpneumonectomy syndrome (PPS) correction. We present a rare case with a PPS in combination with a congenital pectus excavatum. As a pectus excavatus deformity reduces retrosternal space, simple repositioning of the heart is impossible unless combined with a sternum elevation. Presentation of case Two years after left sided pneumonectomy a 30 year old female was admitted with progressive exertional dyspnea and stridor and not able to do her basic activities. Chest CT-scan and bronchoscopy revealed severe right main bronchus stenosis, compression of hilar vessels and the presence of a pectus excavatum deformity. A single stage operative correction was performed with sternum repositioning by a Ravitch’s procedure, pericardial fixation to the right sternal edge and obliteration of the left thoracic cavity with two silicone breast implants. All complaints disappeared within 48 h. Discussion To the best of our knowledge, this is the first report about successful treatment of PPS aggravated by a preexisting pectus excavatum in an adult patient. The durability and migration of the silicone implants and the volume reduction of the pericardial sac during fixation to the sternum continues to remain a concern. Conclusion Single stage correction of PPS and pectus deformity is feasible and seems to be the appropriate treatment for both pathologies. |
| Databáze: | OpenAIRE |
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