The Sternal Turn Over Procedure with Preservation of the Internal Mammary Vessel and Rectus Abdominis Muscle Pedicles for the Repair of Severe Pectus Excavatum

Authors

  • Teeravit Phanchaipetch Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Woravong Slisatkorn Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Punnarerk Thongchareon Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Thaworn Subtaweesin Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Samphant Pornvilawan Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Pansak Laksanabunsong Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Somchai Sriyoschati Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University

Keywords:

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Abstract

Pectus excavatum or funnel chest is one of the most common congenital chest wall deformities. Surgical correction should be considered for all patients with moderate to severe deformities because of the significant cosmetic and psychological improvement, subjective increase in exercise tolerance, documented changes in the cardiac and respiratory status, and prevention of the development of scoliosis after surgical intervention in these patients.
     The sternal turn over procedure with preserved internal mammary vessels and rectus abdominis muscle pedicles for the corrective repair of severe pectus excavatum, involves resection of the deformed thoracic wall, sternum and ribs, preserving an attachment of the rectus abdominis muscle,and a vascular pedicle of the internal mammary vessel. A short segment resection above the ipsilateralcostal cartilage is mandatory to allow reposition of the vascular pedicle onto the presternal surface after turn over of the sternum. Multiple corrective osteotomy and costoplasty must be completed before refixing the sternum and ribs.
     The modified sternal turn over procedure restores the sternal blood supply and should be applied to the severe form of pectus excavatum which needs extensive and multiple bony resection. The procedure has been applied to a boy and a girl aged 5 years. At a three year follow up, the results obtained are excellent.

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Published

01-01-2002

How to Cite

Phanchaipetch, T. ., Slisatkorn, W. ., Thongchareon, P. ., Subtaweesin, T. ., Pornvilawan, S., Laksanabunsong, P. ., & Sriyoschati, S. . (2002). The Sternal Turn Over Procedure with Preservation of the Internal Mammary Vessel and Rectus Abdominis Muscle Pedicles for the Repair of Severe Pectus Excavatum. Siriraj Medical Journal, 54(1), 19–26. Retrieved from https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/244995

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Original Article