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TitleA new methodology for assessment of pectus excavatum correction after bar removal in Nuss procedure: preliminary study
Author(s)Fonseca, João Luís Gomes
Vilaça, João Luis Araújo Martins
Henriques-Coelho, Tiago
Direito-Santos, Bruno
Pinho, António C.M.
Fonseca, Jaime C.
Correia-Pinto, Jorge
KeywordsNuss procedure
Pectus excavatum
3D surface analysis
3D surface scanning
Issue date28-Jul-2017
JournalJournal of Pediatric Surgery
CitationGomes-Fonseca, J., Vilaça, J. L., Henriques-Coelho, T., Direito-Santos, B., Pinho, A. C., Fonseca, J. C., & Correia-Pinto, J. (2017). A new methodology for assessment of pectus excavatum correction after bar removal in Nuss procedure: Preliminary study. Journal of pediatric surgery, 52(7), 1089-1097
Abstract(s)Purpose: The objective is to present a new methodology to assess quantitatively the impact of bar removal on the anterior chest wall, among patients with pectus excavatum who have undergone the Nuss procedure, and present a preliminary study using this methodology. Methods: We propose to acquire, for each patient, the surface of the anterior chest wall using a three-dimensional laser scanner at subsequent time points (short term: before and after surgery; long term: follow-up visit, 6 months, and 12 months after surgery). After surfaces postprocessing, the changes are assessed by overlapping and measuring the distances between surfaces. In this preliminary study, three time points were acquired and two assessments were performed: before vs after bar removal (early) and before vs 2-8 weeks after bar removal (interim). In 21 patients, the signed distances and volumes between surfaces were computed and the data analysis was performed. Results: This methodology revealed useful for monitoring changes in the anterior chest wall. On average, the mean, maximum, and volume variations, in the early assessment, were -0.1 +/- 0.1 cm, -0.6 +/- 0.2 cm, and 47.8 +/- 22.2 cm(3), respectively; and, in the interim assessment, were -0.5 +/- 0.2 cm, -1.3 +/- 0.4 cm, and 122.1 +/- 47.3 cm3, respectively (p < 0.05). Data analysis revealed that the time the bar was in situ was inversely and significantly correlated with postretraction and was a relevant predictor of its decrease following surgery (p < 0.05). Additionally, gender and age suggested influencing the outcome. Conclusions: This methodology is novel, objective and safe, helping on follow-up of pectus excavatum patients. Moreover, the preliminary study suggests that the time the bar was in situ may be the main determinant of the anterior chest wall retraction following bar removal. Further studies should continue to corroborate and reinforce the preliminary findings, by increasing the sample size and performing long-term assessments.
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Appears in Collections:DEI - Artigos em revistas internacionais
ICVS - Artigos em Revistas Internacionais com Referee

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