Details

Autor(en) / Beteiligte

• Eldredge, R Scott
• Ochoa, Brielle
• Khoury, Emily
• Mihalcin, Kristin
• Ostlie, Daniel
• Lee, Justin
• McMahon, Lisa
• Notrica, David
• Padilla, Benjamin E.

Titel

Long-Term Sensory Function 3 years after Minimally Invasive Repair of Pectus Excavatum with Cryoablation

Ist Teil von

• Journal of pediatric surgery, 2024-03, Vol.59 (3), p.379-384

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Minimally invasive repair of pectus excavatum (MIRPE) with intercostal nerve cryoablation (Cryo) decreases length of hospitalization and opioid use, but long-term recovery of sensation has been poorly described. The purpose of this study was to quantify long-term hypoesthesia and neuropathic pain after MIRPE with Cryo. A prospective cohort study was conducted single-institution of patients ≤21 years who presented for bar removal. Consented patients underwent chest wall sensory testing and completed neuropathic pain screening. Chest wall hypoesthesia to cold, soft touch, and pinprick were measured as the percent of the treated anterior chest wall surface area (TACWSA); neuropathic pain was evaluated by questionnaire. The study enrolled 47 patients; 87% male; median age 18.4 years. The median bar dwell time was 2.9 years. A median of 2 bars were placed; 80.9% were secured with pericostal sutures. At enrollment, 46.8% of patients had identifiable chest wall hypoesthesia. The mean percentage of TACWSA with hypoesthesia was 4.7 ± 9.3% (cold), 3.9 ± 7.7% (soft touch), and 5.9 ± 11.8% (pinprick). Hypoesthesia to cold was found in 0 dermatomes in 62%, 1 dermatome in 11%, 2 dermatomes in 17% and ≥3 dermatomes in 11%. T5 was the most common dermatome with hypoesthesia. Neuropathic symptoms were identified by 13% of patients; none required treatment. In long-term follow up after MIRPE with Cryo, 46.8% of patients experienced some chest wall hypoesthesia; the average TACWSA with hypoesthesia was 4–6%. Hypoesthesia was mostly limited to 1–2 dermatomes, most commonly T5. Chronic symptomatic neuropathic pain was rare. Level IV. •Three years following the minimally invasive repair of pectus excavatum with intercostal nerve cryoablation, pediatric patient often develop chest wall hypoesthesia, which is limited to one or two dermatomes.•The presence of chest wall hypoesthesia does not lead to significant morbidity in pediatric patients.•The presence of chronic clinically significant neuropathic is rare three years following the minimally invasive repair of pectus excavatum with intercostal nerve cryoablation