Integral classification method of thoracic deformity_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 WANG Wenlin , CHEN Chunmei , LI Xuejun , LONG Weiguang

Department of Cardiothoracic Surgery, Guangdong Second Provincial General Hospital, Guangzhou, 510317, P.R.China;

Corresponding author：

WANG Wenlin, Email: willinew@126.com

Keywords：

Thoracic deformity; classification method; integral classification method

DOI：

10.7507/1007-4848.201711030

Video：

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Objective To introduce an integral classification method of thoracic deformity. Methods From March 2015 to March 2017, 869 patients with thoracic deformity were observed. The patients were classified according to the traditional classification method at first, and then were classified according to the integral classification method. According to the standard plane of the normal chest wall, the chest deformities were classified into types Ⅰ and Ⅱ: those below the plane belonged to type Ⅰ, and those above the plane belonged to type Ⅱ. Then two types were divided into subtypes Ⅰ-a, Ⅰ-b, Ⅰ-c, Ⅰ-d, Ⅰ-e, Ⅰ-f, Ⅰ-g and Ⅱ-a, Ⅱ-b, Ⅱ-c, Ⅱ-d according to the specific characteristics of malformation. Results There were 840 patients included in the classification system, accounting for 96.7% of the total patients, and the remaining 29 (3.3%) were complicated malformations, which could not be accurately described by using a single classification type. Compared with the traditional classification methods, patients with pectus excavatum and pectus carinatum were divided into different subtypes. Poland syndrome did not exist any longer, and Dove chest alone became the type Ⅱ-c. Conclusion Integral classification method is a simple and practical classification method. Since the method directly depends on the characteristics of malformation which is related to the operation, it plays a guiding role in the operation. But its superiority needs to be further confirmed.

Citation： WANG Wenlin, CHEN Chunmei, LI Xuejun, LONG Weiguang. Integral classification method of thoracic deformity. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(11): 981-985. doi: 10.7507/1007-4848.201711030 Copy

1.	Nuss D, Obermeyer RJ, Kelly RE Jr. Pectus excavatum from a pediatric surgeon's perspective. Ann Cardiothorac Surg, 2016, 5(5): 493-500.
2.	Park HJ, Lee SY, Lee CS, et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg, 2004, 77(1): 289-295.
3.	Park HJ, Lee IS, Kim KT. Extreme eccentric canal type pectus excavatum: morphological study and repair techniques. Eur J Cardiothorac Surg, 2008, 34(1): 150-154.
4.	Schwabegger AH. Pectus excavatum repair from a plastic surgeon's perspective. Ann Cardiothorac Surg, 2016, 5(5): 501-512.
5.	王文林, 陈春梅, 龙伟光, 等. 鸡胸发病机理的分析. 实用医学杂志, 2015, 31(增): 313-314.
6.	王文林. 沟状胸的命名与形态学特点. 实用医学杂志, 2016, 32(2): 335-336.
7.	王文林. 鞍状胸的命名与形态学特征. 实用医学杂志, 2017, 33(增): 380-381.
8.	王文林. 侧胸壁局限性凹陷的命名. 实用医学杂志, 2015, 31(增): 196.
9.	王文林, 陈春梅, 龙伟光, 等. 不对称胸廓畸形的单侧矫形手术. 实用医学杂志, 2015, 31(增): 349-350.
10.	Kelly RE Jr. Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg, 2008, 17(3): 181-193.
11.	Kelly RE Jr, Obermeyer RJ, Nuss D. Diminished pulmonary function in pectus excavatum: from denying the problem to finding the mechanism. Ann Cardiothorac Surg, 2016, 5(5): 466-475.
12.	Andreetti C, D’Andrilli A, Venuta F, et al. Sub-axillary access with the use of costal cartilages articulated bars for correction of pectus carinatum. Interact Cardiovasc Thorac Surg, 2013, 16(2): 209-210.
13.	Oncel M, Tezcan B, Akyol KG, et al. Clinical experience of repair of pectus excavatum and carinatum deformities. Cardiovasc J Afr, 2013, 24(8): 318-321.
14.	Openshaw P, Edwards S, Helms P. Changes in rib cage geometry during childhood. Thorax, 1984, 39(8): 624-627.
15.	Kanagaratnam A, Phan S, Tchantchaleishvili V, et al. Ravitch versus Nuss procedure for pectus excavatum: systematic review and meta-analysis. Ann Cardiothorac Surg, 2016, 5(5): 409-421.
16.	Nuss D, Obermeyer RJ, Kelly RE. Nuss bar procedure: past, present and future. Ann Cardiothorac Surg, 2016, 5(5): 422-433.
17.	Park HJ, Kim KS. The sandwich technique for repair of pectus carinatum and excavatum/carinatum complex. Ann Cardiothorac Surg, 2016, 5(5): 434-439.
18.	Maagaard M, Heiberg J. Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature. Ann Cardiothorac Surg, 2016, 5(5): 485-492.
19.	Pilegaard HK. Single centre experience on short bar technique for pectus excavatum. Ann Cardiothorac Surg, 2016, 5(5): 450-455.
20.	Kim HK, Yoon JY, Han KN, et al. Effect of the Nuss procedure on the physical development of patients with pectus excavatum. Ann Thorac Cardiovasc Surg, 2016, 22(6): 327-332.
21.	王文林, 龙伟光, 陈春梅, 等. 鸡胸的超微创手术. 实用医学杂志, 2015, 31(5): 863-864.
22.	王文林. 二次漏斗胸手术39例临床分析. 中国胸心血管外科临床杂志, 2016, 23(10): 1026-1028.

1. Nuss D, Obermeyer RJ, Kelly RE Jr. Pectus excavatum from a pediatric surgeon's perspective. Ann Cardiothorac Surg, 2016, 5(5): 493-500.
2. Park HJ, Lee SY, Lee CS, et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg, 2004, 77(1): 289-295.
3. Park HJ, Lee IS, Kim KT. Extreme eccentric canal type pectus excavatum: morphological study and repair techniques. Eur J Cardiothorac Surg, 2008, 34(1): 150-154.
4. Schwabegger AH. Pectus excavatum repair from a plastic surgeon's perspective. Ann Cardiothorac Surg, 2016, 5(5): 501-512.
5. 王文林, 陈春梅, 龙伟光, 等. 鸡胸发病机理的分析. 实用医学杂志, 2015, 31(增): 313-314.
6. 王文林. 沟状胸的命名与形态学特点. 实用医学杂志, 2016, 32(2): 335-336.
7. 王文林. 鞍状胸的命名与形态学特征. 实用医学杂志, 2017, 33(增): 380-381.
8. 王文林. 侧胸壁局限性凹陷的命名. 实用医学杂志, 2015, 31(增): 196.
9. 王文林, 陈春梅, 龙伟光, 等. 不对称胸廓畸形的单侧矫形手术. 实用医学杂志, 2015, 31(增): 349-350.
10. Kelly RE Jr. Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg, 2008, 17(3): 181-193.
11. Kelly RE Jr, Obermeyer RJ, Nuss D. Diminished pulmonary function in pectus excavatum: from denying the problem to finding the mechanism. Ann Cardiothorac Surg, 2016, 5(5): 466-475.
12. Andreetti C, D’Andrilli A, Venuta F, et al. Sub-axillary access with the use of costal cartilages articulated bars for correction of pectus carinatum. Interact Cardiovasc Thorac Surg, 2013, 16(2): 209-210.
13. Oncel M, Tezcan B, Akyol KG, et al. Clinical experience of repair of pectus excavatum and carinatum deformities. Cardiovasc J Afr, 2013, 24(8): 318-321.
14. Openshaw P, Edwards S, Helms P. Changes in rib cage geometry during childhood. Thorax, 1984, 39(8): 624-627.
15. Kanagaratnam A, Phan S, Tchantchaleishvili V, et al. Ravitch versus Nuss procedure for pectus excavatum: systematic review and meta-analysis. Ann Cardiothorac Surg, 2016, 5(5): 409-421.
16. Nuss D, Obermeyer RJ, Kelly RE. Nuss bar procedure: past, present and future. Ann Cardiothorac Surg, 2016, 5(5): 422-433.
17. Park HJ, Kim KS. The sandwich technique for repair of pectus carinatum and excavatum/carinatum complex. Ann Cardiothorac Surg, 2016, 5(5): 434-439.
18. Maagaard M, Heiberg J. Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature. Ann Cardiothorac Surg, 2016, 5(5): 485-492.
19. Pilegaard HK. Single centre experience on short bar technique for pectus excavatum. Ann Cardiothorac Surg, 2016, 5(5): 450-455.
20. Kim HK, Yoon JY, Han KN, et al. Effect of the Nuss procedure on the physical development of patients with pectus excavatum. Ann Thorac Cardiovasc Surg, 2016, 22(6): 327-332.
21. 王文林, 龙伟光, 陈春梅, 等. 鸡胸的超微创手术. 实用医学杂志, 2015, 31(5): 863-864.
22. 王文林. 二次漏斗胸手术39例临床分析. 中国胸心血管外科临床杂志, 2016, 23(10): 1026-1028.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Integral classification method of thoracic deformity

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