Pectus excavatum repair using bridge fixation system

Abstract

Background The stability of the pectus bar is an important determinant of the success of pectus excavatum repair surgery. In practice, several different types of fixation method are in use for stabilizing pectus bars. The aim of this study was to compare the performance of the bridge fixation system with previous fixation systems for stabilizing pectus bars. Methods We performed a retrospective review of 1760 pectus excavatum repair cases conducted in the Thoracic Department of Choray Hospital and its satellite hospitals, between 2007 and 2017. We compared the results of 560 patients who had the bridge fixation system with the previous 1200 patients who had other fixation techniques. Results The bridge fixation system with 2 bars in 560 patients gave better results in terms of bar stabilization, operative time, and postoperative complications, compared to the previous 1200 patients who had other stabilization techniques. The average skin-to-skin surgery time using the bridge fixation system was 55 min. Of the 560 cases, only one patient showed trivial one bar dislocation, and one had a postoperative complication (pneumothorax). Conclusions We found the bridge fixation system to be superior not only in terms of stabilizing the bars but also for minimizing the time of surgery and postoperative complications, compared to other fixation systems. The bridge fixation system with 2 bars showed excellent results. Use of 3 bars is not necessary. One bar was used in the other fixation techniques and the results were found to be inferior compared to those using 2 bars.