Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 191-199 |
| Number of pages | 9 |
| Journal | Annals of Thoracic Surgery |
| Volume | 116 |
| Issue number | 1 |
| Early online date | 2023 |
| DOIs | |
| Publication status | Published - Jul 2023 |
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In: Annals of Thoracic Surgery, Vol. 116, No. 1, 07.2023, p. 191-199.
Research output: Contribution to journal › Review article › Academic › peer-review
TY - JOUR
T1 - Pectus Excavatum
T2 - Consensus and Controversies in Clinical Practice
AU - Chest Wall International Group Collaborator Group
AU - Janssen, Nicky
AU - Daemen, Jean H. T.
AU - van Polen, Elise J.
AU - Coorens, Nadine A.
AU - Jansen, Yanina J. L.
AU - Franssen, Aimée J. P. M.
AU - Hulsewé, Karel W. E.
AU - Vissers, Yvonne L. J.
AU - Haecker, Frank-Martin
AU - Milanez de Campos, Jose R.
AU - de Loos, Erik R.
AU - Abramson, Horacio A.
AU - Aguiar, Wolfgang W. S.
AU - Alder, Adam C.
AU - Ambriz-González, Gabriela
AU - Andrews, James
AU - Backhus, Leah M.
AU - de Beer, Sjoerd A.
AU - de Campos, José Ribas M.
AU - Chu, Chih-Chun
AU - Currie, Bruce G.
AU - Darlong, Laleng M.
AU - Dhannapuneni, Ramana
AU - Doody, Daniel P.
AU - Elmo, Gastón
AU - Emil, Sherif
AU - Villacampa, Ricardo Escartín
AU - Ferrari, Paolo A.
AU - Fortmann, Caroline
AU - Goretsky, Michael J.
AU - Hebra, Andre
AU - van der Heide, Stefan M.
AU - Hendriks, Jeroen M. H.
AU - Hensens, Ab G.
AU - Heyman, Stijn R. G.
AU - van Huijstee, Pieter J.
AU - Infante, Maurizio V.
AU - Jaroszewski, Dawn E.
AU - Kelly, Robert E.
AU - Marres, Geertruid M. H.
AU - von Meyenfeldt, Erik M.
AU - Omanik, Pavol
AU - Oomen, Matthijs W.
AU - Peredo, Alfredo W.
AU - Perez-Alonso, David
AU - Petersen, Claus
AU - Pilegaard, Hans K.
AU - Prada-Arias, Marcos
AU - Rebhandl, Winfried
AU - Zarama, Ricardo M.
N1 - Funding Information: CWIG Collaborator Group: Horacio A. Abramson,1 Wolfgang W. S. Aguiar,2 Adam C. Alder,3 Gabriela Ambriz-González,4 James Andrews,5 Leah M. Backhus,6 Sjoerd A. de Beer,7 Jose R. Milanez de Campos,8 Chih-Chun Chu,9 Bruce G. Currie,10 Laleng M. Darlong,11 Ramana Dhannapuneni,12 Daniel P. Doody,13 Gastón Elmo,14 Sherif Emil,15 Ricardo Escartín Villacampa,16 Paolo A. Ferrari,17 Caroline Fortmann,18 Michael J. Goretsky,19 Frank-Martin Haecker,20 Andre Hebra,21 Stefan M. van der Heide,22 Jeroen M. H. Hendriks,23 Ab G. Hensens,24 Stijn R. G. Heyman,25 Pieter J. van Huijstee,26 Karel W. E. Hulsewé,27 Maurizio V. Infante,28 Yanina J. L. Jansen,27 Dawn E. Jaroszewski,29 Robert E. Kelly Jr,19,30 Erik R. de Loos,27 Geertruid M. H. Marres,31 Erik M. von Meyenfeldt,31 Pavol Omanik,32 Matthijs W. Oomen,7 Alfredo W. Peredo,33 David Perez-Alonso,34 Claus Petersen,18 Hans K. Pilegaard,35 Marcos Prada-Arias,36 Winfried Rebhandl,37 Ricardo M. Zarama,38 Daniel P. Ryan,39 Frederic De Ryck,40 Ivan Schewitz,41 Miguel L. Tedde,42 Mathew Thomas,43 Carlos A. De La Torre,44 Hans G. L. Van Veer,45 Dirk Vervloessem,25 Yvonne L. J. Vissers,27 Caroline Van De Wauwer,46 Cosmas D. Wimmer,47 Huseyin Yildiran,48 Mustafa Yuksel,49 and Gerda W. Zijp50, 1Cetrangolo Hospital Provincia de Buenos Aires, Buenos Aires, Argentina; 2Sócio-fundador do Serviço de Cirurgia Torácica de Recife (SECITOR), Recife, Brazil; 3Center for Pectus and Chest Wall Anomalies, Children's Health, Plano, Texas; 4Western National Medical Center, Mexican Institute of Social Security, Col. Juárez, México City, Mexico; 5Royal Hospital for Children, Glasgow, United Kingdom; 6Stanford University, Stanford, California; 7Amsterdam University Medical Center, Amsterdam, the Netherlands; 8Hospital das Clinicas, São Paulo, Brazil; 9Country Hospital Taipei, Taipei City, Taiwan, Province of China; 10Sydney Children's Hospital, Randwick, Sydney, New South Wales, Australia; 11Rajiv Gandhi Cancer Institute, Delhi, India; 12Alder Hey Children's Hospital National Health Service Trust, Liverpool, United Kingdom; 13Massachusetts General Hospital, Boston, Massachusetts; 14Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; 15Chest Wall Anomaly Center, Shriners Hospital for Children Canada, McGill University, Montreal, Quebec, Canada; 16Miguel Servet Children's Hospital, Zaragoza, Spain; 17“A. Businco” Oncology Hospital, Azienda di Rilievo Nazionale ed Alta Specializzazione G. Brotzu, Cagliari, Italy; 18Hannover Medical School, Hannover, Germany; 19Children's Hospital of The King's Daughters, Norfolk, Virginia; 20Children's Hospital of Eastern Switzerland, St Gallen, Switzerland; 21Golisano Children's Hospital of Southwest Florida, Fort Myers, Florida; 22Radboud University Medical Centre, Nijmegen, the Netherlands; 23University Hospital Antwerp, Antwerp, Belgium; 24Medisch Spectrum Twente, Enschede, the Netherlands; 25ZNA Q. Paola Children's Hospital and Saffier Network, Antwerp, Belgium; 26Haga Teaching Hospital, The Hague, the Netherlands; 27Zuyderland Medical Center, Heerlen, the Netherlands; 28University and Hospital Trust, Borgo Trento, Verona, Italy; 29Mayo Clinic Arizona, Phoenix, Arizona; 30Eastern Virginia Medical School Norfolk, Virginia; 31Albert Schweitzer Hospital, Dordrecht, the Netherlands; 32National Institute of Children's Diseases, Bratislava, Slovak Republic; 33Consejo de Certificación de Profesionales Médicos (CCPM), Buenos Aires, Argentina; 34Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain; 35Aarhus University Hospital, Aarhus University, Aarhus, Denmark; 36University Hospital Vigo, Vigo, Spain; 37Medical University of Vienna, Vienna, Austria; 38Hospital Infantil Los Ángeles, Narino, Colombia; 39Massachusetts General Hospital for Children, Boston, Massachusetts; 40University Hospital Ghent, Ghent, Belgium; 41Pretoria University, Pretoria, South Africa; 42Heart Institute, Instituto do Coração Hospital das Clinicas and University of São Paulo, São Paulo, Brazil; 43Mayo Clinic Jacksonville, Jacksonville, Florida; 44University Hospital La Paz, Madrid, Spain; 45University Hospitals Leuven and KU Leuven, Leuven, Belgium; 46University Medical Center Groningen, Groningen, the Netherlands; 47Thoraxklinik Heidelberg, Heidelberg, Germany; 48Selçuk University Medical Faculty, Selcuklu, Konya, Turkey; 49Pektus Klinik İstanbul, İstanbul, Turkey; and 50Juliana Children's Hospital, The Hague, the Netherlands, The authors have no funding sources to disclose. Karel W. E. Hulsewe reports a consulting or advisory relationship with Johnson & Johnson and being a board member of the Dutch Federatie Medisch Specialisten (Federation of Medical Specialists), a federation of the 33 professional associations for medical specialists in the Netherlands. Yvonne L. J. Vissers reports a consulting or advisory relationship with Johnson & Johnson and being a board member of Nederlandse Vereniging voor Longchirurgie (NVvL). Erik R. de Loos reports consulting or advisory relationships with Johnson & Johnson and Baxter, and reports being a board member of the Dutch Advanced Trauma Life Support Association and Faculty of the European Society for Thoracic Surgery's Chest Wall Course. Frank-Martin Haecker reports being an executive board member and past president of the Chest Wall International Group. Jose Ribas Milanez de Campos reports being an executive board member and current president of Chest Wall International Group. The other authors have no conflicts of interest to disclose. Publisher Copyright: © 2023 The Society of Thoracic Surgeons
PY - 2023/7
Y1 - 2023/7
N2 - Background: Pectus excavatum is the most common congenital anterior chest wall deformity. Currently, a wide variety of diagnostic protocols and criteria for corrective surgery are being used. Their use is predominantly based on local preferences and experience. To date, no guideline is available, introducing heterogeneity of care as observed in current daily practice. The aim of this study was to evaluate consensus and controversies regarding the diagnostic protocol, indications for surgical correction, and postoperative evaluation of pectus excavatum. Methods: The study consisted of 3 consecutive survey rounds evaluating agreement on different statements regarding pectus excavatum care. Consensus was achieved if at least 70% of participants provided a concurring opinion. Results: All 3 rounds were completed by 57 participants (18% response rate). Consensus was achieved on 18 of 62 statements (29%). Regarding the diagnostic protocol, participants agreed to routinely include conventional photography. In the presence of cardiac impairment, electrocardiography and echocardiography were indicated. Upon suspicion of pulmonary impairment, spirometry was recommended. In addition, consensus was reached on the indications for corrective surgery, including symptomatic pectus excavatum and progression. Participants moreover agreed that a plain chest radiograph must be acquired directly after surgery, whereas conventional photography and physical examination should both be part of routine postoperative follow-up. Conclusions: Through a multiround survey, international consensus was formed on multiple topics to aid standardization of pectus excavatum care.
AB - Background: Pectus excavatum is the most common congenital anterior chest wall deformity. Currently, a wide variety of diagnostic protocols and criteria for corrective surgery are being used. Their use is predominantly based on local preferences and experience. To date, no guideline is available, introducing heterogeneity of care as observed in current daily practice. The aim of this study was to evaluate consensus and controversies regarding the diagnostic protocol, indications for surgical correction, and postoperative evaluation of pectus excavatum. Methods: The study consisted of 3 consecutive survey rounds evaluating agreement on different statements regarding pectus excavatum care. Consensus was achieved if at least 70% of participants provided a concurring opinion. Results: All 3 rounds were completed by 57 participants (18% response rate). Consensus was achieved on 18 of 62 statements (29%). Regarding the diagnostic protocol, participants agreed to routinely include conventional photography. In the presence of cardiac impairment, electrocardiography and echocardiography were indicated. Upon suspicion of pulmonary impairment, spirometry was recommended. In addition, consensus was reached on the indications for corrective surgery, including symptomatic pectus excavatum and progression. Participants moreover agreed that a plain chest radiograph must be acquired directly after surgery, whereas conventional photography and physical examination should both be part of routine postoperative follow-up. Conclusions: Through a multiround survey, international consensus was formed on multiple topics to aid standardization of pectus excavatum care.
UR - http://www.scopus.com/inward/record.url?scp=85159067773&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.athoracsur.2023.02.059
DO - https://doi.org/10.1016/j.athoracsur.2023.02.059
M3 - Review article
C2 - 36997016
SN - 0003-4975
VL - 116
SP - 191
EP - 199
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 1
ER -