Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspective
Introduction: The crane technique is used to facilitate sternal elevation to provide safe mediastinal passage during the Nuss procedure. The aim was to objectively quantitate the elevation of the crane by 3-dimensional chest images acquired during the Nuss procedure. Methods: A prospective cohort st...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-10-01
|
| Series: | JTCVS Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250721004806 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849239339760877568 |
|---|---|
| author | Erik R. de Loos, MD Jean H.T. Daemen, MD Nadine A. Coorens, MSc Jos G. Maessen, MD, PhD Yvonne L.J. Vissers, MD, PhD Karel W.E. Hulsewé, MD, PhD |
| author_facet | Erik R. de Loos, MD Jean H.T. Daemen, MD Nadine A. Coorens, MSc Jos G. Maessen, MD, PhD Yvonne L.J. Vissers, MD, PhD Karel W.E. Hulsewé, MD, PhD |
| author_sort | Erik R. de Loos, MD |
| collection | DOAJ |
| description | Introduction: The crane technique is used to facilitate sternal elevation to provide safe mediastinal passage during the Nuss procedure. The aim was to objectively quantitate the elevation of the crane by 3-dimensional chest images acquired during the Nuss procedure. Methods: A prospective cohort study was conducted. Patients undergoing the Nuss procedure were eligible. Sternal elevation was achieved by the crane technique providing a simultaneous lift of the anterior chest wall and reduction of the pectus excavatum depth. Both effects were evaluated. Three-dimensional surface images were acquired before incision, following sternal lift, and after bar implantation and quantitatively compared. Reduction of the external pectus excavatum depth was expressed as a percentage. Results: Thirty patients were included. Ninety percent were male, with a median age of 15.5 years (interquartile range [IQR], 14.5-17.4), Haller index of 3.56 (IQR, 3.09-4.65), and external pectus depth of 18 mm (IQR, 11-23). Sternal elevation by the crane provided a median 78% (IQR, 63-100) reduction of the deformity, corresponding with a residual depth of 3 mm (IQR, 0-7). The percentual reduction diminished with increasing depth of the sternal depression (correlation, –0.86). Besides reducing the deformity, the crane caused an elevation of the anterior chest over a large surface area with a maximum lift of 26 mm (IQR, 19-32). Conclusions: The crane is an effective sternal elevation technique, providing 78% reduction of the sternal depression, although its effect lessens with increasing depth. In addition, it produces an elevation of the anterior chest over a large surface area. |
| format | Article |
| id | doaj-art-e7d79a72a84b4a3180cdf6d85757ac6d |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-e7d79a72a84b4a3180cdf6d85757ac6d2025-08-20T04:01:02ZengElsevierJTCVS Techniques2666-25072021-10-01916717510.1016/j.xjtc.2021.05.028Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspectiveErik R. de Loos, MD0Jean H.T. Daemen, MD1Nadine A. Coorens, MSc2Jos G. Maessen, MD, PhD3Yvonne L.J. Vissers, MD, PhD4Karel W.E. Hulsewé, MD, PhD5Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands; Address for reprints: Erik R. de Loos, MD, Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Henri Dunantstraat 5, 6419PC, Heerlen, The Netherlands.Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands; Faculty of Health, Medicine and Life Sciences (FHML), School for Oncology and Developmental Biology (GROW), Maastricht, The NetherlandsDivision of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, The NetherlandsDepartment of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Faculty of Health, Medicine and Life Sciences (FHML), Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The NetherlandsDivision of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, The NetherlandsDivision of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, The NetherlandsIntroduction: The crane technique is used to facilitate sternal elevation to provide safe mediastinal passage during the Nuss procedure. The aim was to objectively quantitate the elevation of the crane by 3-dimensional chest images acquired during the Nuss procedure. Methods: A prospective cohort study was conducted. Patients undergoing the Nuss procedure were eligible. Sternal elevation was achieved by the crane technique providing a simultaneous lift of the anterior chest wall and reduction of the pectus excavatum depth. Both effects were evaluated. Three-dimensional surface images were acquired before incision, following sternal lift, and after bar implantation and quantitatively compared. Reduction of the external pectus excavatum depth was expressed as a percentage. Results: Thirty patients were included. Ninety percent were male, with a median age of 15.5 years (interquartile range [IQR], 14.5-17.4), Haller index of 3.56 (IQR, 3.09-4.65), and external pectus depth of 18 mm (IQR, 11-23). Sternal elevation by the crane provided a median 78% (IQR, 63-100) reduction of the deformity, corresponding with a residual depth of 3 mm (IQR, 0-7). The percentual reduction diminished with increasing depth of the sternal depression (correlation, –0.86). Besides reducing the deformity, the crane caused an elevation of the anterior chest over a large surface area with a maximum lift of 26 mm (IQR, 19-32). Conclusions: The crane is an effective sternal elevation technique, providing 78% reduction of the sternal depression, although its effect lessens with increasing depth. In addition, it produces an elevation of the anterior chest over a large surface area.http://www.sciencedirect.com/science/article/pii/S2666250721004806crane techniquesternal elevationNuss procedurepectus excavatum |
| spellingShingle | Erik R. de Loos, MD Jean H.T. Daemen, MD Nadine A. Coorens, MSc Jos G. Maessen, MD, PhD Yvonne L.J. Vissers, MD, PhD Karel W.E. Hulsewé, MD, PhD Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspective JTCVS Techniques crane technique sternal elevation Nuss procedure pectus excavatum |
| title | Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspective |
| title_full | Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspective |
| title_fullStr | Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspective |
| title_full_unstemmed | Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspective |
| title_short | Sternal elevation by the crane technique during pectus excavatum repair: A quantitative analysisCentral MessagePerspective |
| title_sort | sternal elevation by the crane technique during pectus excavatum repair a quantitative analysiscentral messageperspective |
| topic | crane technique sternal elevation Nuss procedure pectus excavatum |
| url | http://www.sciencedirect.com/science/article/pii/S2666250721004806 |
| work_keys_str_mv | AT erikrdeloosmd sternalelevationbythecranetechniqueduringpectusexcavatumrepairaquantitativeanalysiscentralmessageperspective AT jeanhtdaemenmd sternalelevationbythecranetechniqueduringpectusexcavatumrepairaquantitativeanalysiscentralmessageperspective AT nadineacoorensmsc sternalelevationbythecranetechniqueduringpectusexcavatumrepairaquantitativeanalysiscentralmessageperspective AT josgmaessenmdphd sternalelevationbythecranetechniqueduringpectusexcavatumrepairaquantitativeanalysiscentralmessageperspective AT yvonneljvissersmdphd sternalelevationbythecranetechniqueduringpectusexcavatumrepairaquantitativeanalysiscentralmessageperspective AT karelwehulsewemdphd sternalelevationbythecranetechniqueduringpectusexcavatumrepairaquantitativeanalysiscentralmessageperspective |