Background: The minimally invasive pectus carinatum (PC) surgery described by Abramson has been performed in many centers. We have been using this technique since 2011. This article describes our experience with PC correction. Methods: Between 2011 and 2016, 32 patients at our institution underwent minimally invasive repair of a PC deformity. All patients presented with cosmetic complaints. The deformity involved the lower sternum (all had chondrogladiolar type PC), and three patients had asymmetrical deformities. All operations followed the principles defined by Abramson. Results: Satisfactory esthetic results were achieved in our patients. The hospital stay averaged 5.3 days (range 4-7 days). The most common early complication was pneumothorax, and the most common late complication was wire suture breakage. Conclusion: The Abramson technique is an effective, minimally invasive procedure for PC with shorter operating and hospitalization times and low morbidity rates. (C) 2016 Asian Surgical Association and Taiwan Robotic Surgical Association. Publishing services by Elsevier B.V.

Background: This study aims to systematically examine the cardiopulmonary functions in children with pectus excavatum and to compare the obtained findings with the Haller Index. Methods: Between September 2017 and June 2018, medical records of a total of 31 patients (27 males, 4 females; mean age: 14.8±2.0 years; range, 9 to 18 years) with pectus excavatum were retrospectively analyzed. The patients were divided into Group 1 (3.2) according to the Haller Index. All groups were systematically evaluated based on pulmonary function tests and echocardiography. Forced vital capacity, forced expiratory volume in 1 second, and the forced expiratory volume in 1 second/ forced vital capacity ratio were calculated. Left ventricular enddiastolic diameter, ejection fraction, mitral valve prolapses, and right ventricular cavity in the apical four-chamber position were evaluated with echocardiography. Results: Of the patients, 19.4% were in Group 1, 38.7% in Group 2, and 41.9% in Group 3. The mean Haller Index value was 3.09±0.64. According to pulmonary function test results, 16.1% of the patients had restrictive disease and 6.5% had obstructive disease. There was a negative correlation between the index and forced expiratory volume in 1 second and forced vital capacity, and there was a statistically significant decrease in these values, as the Haller Index increased (p<0.017). There was a significant difference in the ejection fraction among the groups (p<0.001) and, as the Haller Index increased, ejection fraction statistically significantly decreased. Conclusion: Our study results show a negative correlation between the severity of pectus excavatum and pulmonary dysfunction and, as the severity increases, left ventricular function may be affected by the deformity. As a result, there seems to be a significant relationship between the severity of the deformity and cardiopulmonary functions.

In the present study, we aimed to present our experience about retrieval of foreign bodies over a 28-year period. We retrospectively analyzed the files of 22 patients (18 males, 4 females; mean age 34.9 years; range, 9 months to 80 years) who required removal of a foreign body from the tracheobronchial tree between April 1987 and December 2015. A total of 72.7% of the study group were 10 years old or older. There was no history of aspiration in 37% of cases, most often in older patients. Of the 22 unusual foreign bodies, seven (31.8%) were aspirated through permanent tracheostomy. The strangest foreign bodies were grass inflorescences, an acacia thorn, and construction nail. The foreign bodies were removed by rigid bronchoscopy in 18 patients, while thoracotomy was performed in two patients, and pericardiotomy in one patient. No intervention was required in one patient. The elderly and patients with tracheostomies may aspirate unusual foreign bodies. Even if there is no history of aspiration, the differential diagnosis of c ough or dyspnea should include foreign body aspiration.