Abstract
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 cm3, 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.
Levels of evidence
III
Key words
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Article info
Publication history
Published online: January 14, 2017
Accepted:
December 31,
2016
Received in revised form:
December 30,
2016
Received:
March 7,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
