Slipping Rib Syndrome: A review of evaluation, diagnosis and treatment
Slipping rib syndrome (SRS) is an under-diagnosed cause of intermittent, yet often debilitating lower rib and abdominal pain. SRS is caused by a hypermobility of the anterior false ribs that allows the 8th –10th ribs to slip or click as the cartilaginous rib tip abuts or slips under the rib above. Pain occurs from impingement of the intercostal nerve passing along the undersurface of the adjacent rib. Studies consistently find patients reporting months to years of typical pain symptoms, unnecessary tests and procedures prior to diagnosis. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 27, 2018 Category: Pediatrics Authors: Lisa E. McMahon Source Type: research
Chest wall reconstruction after tumor resection
Pediatric chest wall tumors and rare. Malignancies predominate of which sarcomas are the most common. Their resection and the subsequent reconstruction of the chest wall has been a surgical challenge since Dr Frederick W Parham published his first comprehensive account on the subject in 1898. Chest wall reconstruction is age, site and pathology dependent, must preserve long term function and cosmesis, must accommodate future growth and development, and must not be a hindrance to adjuvant radiotherapy. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 27, 2018 Category: Pediatrics Authors: Dr. Gideon Sandler, Dr. Andrea Hayes-Jordan Source Type: research
A Review of Slipping Rib Syndrome: Evaluation, Diagnosis and Treatment
Slipping rib syndrome (SRS) is an under-diagnosed cause of intermittent, yet often debilitating lower rib and abdominal pain. SRS is frequently associated with a popping or slipping sensation, giving it its name. The syndrome is caused by a hypermobility of the anterior false ribs, either from disruption of fibrous articulation, or a congenital deformity that allows for the 8th-10th ribs to slip or click as the cartilaginous rib tip abuts or slips under the rib above. Pain occurs from impingement of the intercostal nerve passing along the undersurface of the adjacent rib. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 27, 2018 Category: Pediatrics Authors: Lisa E. McMahon Source Type: research
Quantification of Pectus Excavatum: Anatomic Indices
Pectus excavatum is the most common chest wall deformity in children. The central portion of the chest is displaced posteriorly relative to the remainder of the anterior chest wall. Quantification of defect severity can be performed with multiple imaging modalities or external thoracic measures, but is most commonly quantified by the Haller Index (HI) or Pectus Correction Index (PCI). These two measures provide a measure of the chest based on cross sectional imaging, most commonly CT scans, allowing for standard comparison and definitions of pectus defects. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 17, 2018 Category: Pediatrics Authors: Joseph A. Sujka, Shawn D. St. Peter Source Type: research
A Review of Anesthetic Considerations and Postoperative Pain Control after the Nuss Procedure
The Nuss procedure is named after Dr. Donald Nuss, who pioneered his technique for the repair of Pectus Excavatum in the late 1990 ’s. In 1998, he published his 10-year experience with the minimally invasive repair [1]. Since then, hospitals across the world have adopted this method of repair for Pectus Excavatum, also known as Minimally Invasive Repair of Pectus Excavatum (MIRPE). (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 17, 2018 Category: Pediatrics Authors: Neil Raj Singhal, Jonathan D. Jerman Source Type: research
Complications Associated with the Minimally Invasive Repair of Pectus Excavatum
The minimally invasive pectus excavatum repair (Nuss repair) is performed by pediatric general surgeons and pediatric and adult thoracic surgeons around the world. Complications related to pediatric surgical procedures are always a major concern for surgeons and their patients, and as with all surgery, especially pectus surgery, complications can be life-threatening. The purpose of this article is to discuss early and late complications of pectus excavatum surgery and potential preventive strategies to minimize them. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 15, 2018 Category: Pediatrics Authors: Michael J. Goretsky, Margaret M. McGuire Source Type: research
The Physiologic Impact of Pectus Excavatum Repair
The adverse physiologic effects of pectus excavatum and subsequent resolution following correction have been a subject of controversy. There are numerous accounts of patients reporting subjective improvement in exercise tolerance after surgery, but studies showing clear and consistent objective data to corroborate this phenomenon physiologically have been elusive. This is partially due to a lack of consistent study methodologies but even more so due to a mere paucity of data. As experts in the repair of pectus excavatum, it is not uncommon for pediatric surgeons to operate on adult patients. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 15, 2018 Category: Pediatrics Authors: Robert J. Obermeyer, Nina S. Cohen, Dawn E. Jaroszewski Source Type: research
Nuss Procedure in the Adult Population for Correction of Pectus Excavatum
Minimally invasive repair of pectus excavatum has been successfully modified for use in adult patients. Many patients present in adulthood with progression of symptoms as the chest wall becomes less compliant with age. A thorough workup is completed including echocardiogram and chest CT to evaluate for anatomic abnormalities. Cardiopulmonary exercise testing is done to quantify the physiologic impact. Modifications of the original Nuss procedure required to allow for successful adult repair include the use of forced sternal elevation, the use of multiple bars, medial bar fixation, and interspace support to prevent bar rota...
Source: Seminars in Pediatric Surgery - May 14, 2018 Category: Pediatrics Authors: Cristine S. Velazco, Reza Arsanjani, Dawn E. Jaroszewski Source Type: research
Outcomes, Quality of Life, and Long-Term Results after Pectus Repair from around the Globe
The procedure introduced by Donald Nuss in 1997 at the American Pediatric Surgical Association meeting has now been adopted by pediatric, thoracic, and plastic surgeons around the globe. Since its introduction, the Nuss procedure has been the subject of intense scrutiny. More than 20 years since the original publication, medical centers from around the world have reported their experience with the procedure and robust evidence now supports its safety and efficacy.Additionally, in collaboration with psychologists in Norfolk, a methodology was devised to measure the psychosocial as well as the physical benefits of the proced...
Source: Seminars in Pediatric Surgery - May 14, 2018 Category: Pediatrics Authors: Robert E. Kelly, Antarius Daniel Source Type: research
Modifications to the Nuss procedure for pectus excavatum repair: A 20-year review
In May of 1997 In Dr. Donald Nuss presented a radically new technique for repairing pectus excavatum at the American Pediatric Surgery Association (APSA)1. Prior to the APSA presentation, the standard technique for repair was an open operation involving resection of either all, or sections of the costal cartilage attaching to the sternum.2,3 This was followed by a sternal osteotomy with or without a sternal strut.4 Other techniques included flipping the deformed sternum.5 The procedure described by Dr Nuss eliminated resection of the cartilage a sternal osteotomy. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - May 14, 2018 Category: Pediatrics Authors: David M. Notrica Source Type: research
fm i -- Contents
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Source: Seminars in Pediatric Surgery - April 1, 2018 Category: Pediatrics Source Type: research
fm ii -- Forthcoming topics
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Source: Seminars in Pediatric Surgery - April 1, 2018 Category: Pediatrics Source Type: research
fm i -- Contents
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Source: Seminars in Pediatric Surgery - March 14, 2018 Category: Pediatrics Source Type: research
fm ii -- Forthcoming topics
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Source: Seminars in Pediatric Surgery - March 14, 2018 Category: Pediatrics Source Type: research
Preface
As healthcare providers familiar with behind-the-scenes workings of hospitals and operating rooms, we have grown accustomed to functioning at a high level in an extremely complex work environment. Over the past few decades healthcare complexity has grown exponentially, spanning the entire care continuum. For surgeons, complexity exists for initial access and utilization of care by patients and permeates into shared decision-making regarding treatment. This all occurs before orchestrating the actual day in the operating room or conducting a technically demanding operation. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 15, 2018 Category: Pediatrics Authors: Mehul V. Raval, David H. Rothstein Source Type: research
