Minimally invasive repair of pectus excavatum: analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions

Maria G. Sacco-Casamassima, Seth D. Goldstein, Colin D. Gause, Omar Karim, Maria Michailidou, Fray Dylan Stewart, Paul Colombani, Fizan Abdullah

Research output: Contribution to journalArticle

Abstract

Background: Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown. Study design: The American College of Surgeons 2012 National Surgical Quality Improvement Program-Pediatric (NSQIP-P) participant user file was utilized to identify patients who underwent MIRPE at 50 participant institutions. Outcomes of interest were overall 30-day morbidity, hospital readmission, and reoperation. Results: Chest wall repair designated MIRPE accounted for 0.6 % (n = 264) of all surgical cases included in the NSQIP-P database in 2012. The median age at surgical repair was 15.2 years. Thoracoscopy was used in 83.7 % of cases. No mediastinal injuries or perioperative blood transfusions were identified. The 30-day readmission rate was 3.8 %. Three patients (1.1 %) required re-operation due to the following complications: superficial site infection, bar displacement and pneumothorax. The overall morbidity was 3.8 % with no incidences of mortality. Conclusions: This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.

Original languageEnglish (US)
Pages (from-to)493-499
Number of pages7
JournalPediatric Surgery International
Volume31
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Funnel Chest
Patient Readmission
Quality Improvement
Pediatrics
Morbidity
Thoracoscopy
Incidence
Wounds and Injuries
Thoracic Wall
Pneumothorax
Wound Infection
Reoperation
Blood Transfusion
Databases
Mortality
Infection

Keywords

  • MIRPE
  • NSQIP-Pediatric
  • Outcomes
  • Pectus excavatum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Medicine(all)

Cite this

Sacco-Casamassima, M. G., Goldstein, S. D., Gause, C. D., Karim, O., Michailidou, M., Stewart, F. D., ... Abdullah, F. (2015). Minimally invasive repair of pectus excavatum: analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions. Pediatric Surgery International, 31(5), 493-499. https://doi.org/10.1007/s00383-015-3694-z

Minimally invasive repair of pectus excavatum : analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions. / Sacco-Casamassima, Maria G.; Goldstein, Seth D.; Gause, Colin D.; Karim, Omar; Michailidou, Maria; Stewart, Fray Dylan; Colombani, Paul; Abdullah, Fizan.

In: Pediatric Surgery International, Vol. 31, No. 5, 01.05.2015, p. 493-499.

Research output: Contribution to journalArticle

Sacco-Casamassima, MG, Goldstein, SD, Gause, CD, Karim, O, Michailidou, M, Stewart, FD, Colombani, P & Abdullah, F 2015, 'Minimally invasive repair of pectus excavatum: analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions', Pediatric Surgery International, vol. 31, no. 5, pp. 493-499. https://doi.org/10.1007/s00383-015-3694-z
Sacco-Casamassima, Maria G. ; Goldstein, Seth D. ; Gause, Colin D. ; Karim, Omar ; Michailidou, Maria ; Stewart, Fray Dylan ; Colombani, Paul ; Abdullah, Fizan. / Minimally invasive repair of pectus excavatum : analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions. In: Pediatric Surgery International. 2015 ; Vol. 31, No. 5. pp. 493-499.
@article{4f6bb9fac0ca49bfb4771a557f72587c,
title = "Minimally invasive repair of pectus excavatum: analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions",
abstract = "Background: Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown. Study design: The American College of Surgeons 2012 National Surgical Quality Improvement Program-Pediatric (NSQIP-P) participant user file was utilized to identify patients who underwent MIRPE at 50 participant institutions. Outcomes of interest were overall 30-day morbidity, hospital readmission, and reoperation. Results: Chest wall repair designated MIRPE accounted for 0.6 {\%} (n = 264) of all surgical cases included in the NSQIP-P database in 2012. The median age at surgical repair was 15.2 years. Thoracoscopy was used in 83.7 {\%} of cases. No mediastinal injuries or perioperative blood transfusions were identified. The 30-day readmission rate was 3.8 {\%}. Three patients (1.1 {\%}) required re-operation due to the following complications: superficial site infection, bar displacement and pneumothorax. The overall morbidity was 3.8 {\%} with no incidences of mortality. Conclusions: This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.",
keywords = "MIRPE, NSQIP-Pediatric, Outcomes, Pectus excavatum",
author = "Sacco-Casamassima, {Maria G.} and Goldstein, {Seth D.} and Gause, {Colin D.} and Omar Karim and Maria Michailidou and Stewart, {Fray Dylan} and Paul Colombani and Fizan Abdullah",
year = "2015",
month = "5",
day = "1",
doi = "10.1007/s00383-015-3694-z",
language = "English (US)",
volume = "31",
pages = "493--499",
journal = "Pediatric Surgery International",
issn = "0179-0358",
publisher = "Springer Verlag",
number = "5",

}

TY - JOUR

T1 - Minimally invasive repair of pectus excavatum

T2 - analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions

AU - Sacco-Casamassima, Maria G.

AU - Goldstein, Seth D.

AU - Gause, Colin D.

AU - Karim, Omar

AU - Michailidou, Maria

AU - Stewart, Fray Dylan

AU - Colombani, Paul

AU - Abdullah, Fizan

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background: Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown. Study design: The American College of Surgeons 2012 National Surgical Quality Improvement Program-Pediatric (NSQIP-P) participant user file was utilized to identify patients who underwent MIRPE at 50 participant institutions. Outcomes of interest were overall 30-day morbidity, hospital readmission, and reoperation. Results: Chest wall repair designated MIRPE accounted for 0.6 % (n = 264) of all surgical cases included in the NSQIP-P database in 2012. The median age at surgical repair was 15.2 years. Thoracoscopy was used in 83.7 % of cases. No mediastinal injuries or perioperative blood transfusions were identified. The 30-day readmission rate was 3.8 %. Three patients (1.1 %) required re-operation due to the following complications: superficial site infection, bar displacement and pneumothorax. The overall morbidity was 3.8 % with no incidences of mortality. Conclusions: This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.

AB - Background: Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown. Study design: The American College of Surgeons 2012 National Surgical Quality Improvement Program-Pediatric (NSQIP-P) participant user file was utilized to identify patients who underwent MIRPE at 50 participant institutions. Outcomes of interest were overall 30-day morbidity, hospital readmission, and reoperation. Results: Chest wall repair designated MIRPE accounted for 0.6 % (n = 264) of all surgical cases included in the NSQIP-P database in 2012. The median age at surgical repair was 15.2 years. Thoracoscopy was used in 83.7 % of cases. No mediastinal injuries or perioperative blood transfusions were identified. The 30-day readmission rate was 3.8 %. Three patients (1.1 %) required re-operation due to the following complications: superficial site infection, bar displacement and pneumothorax. The overall morbidity was 3.8 % with no incidences of mortality. Conclusions: This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.

KW - MIRPE

KW - NSQIP-Pediatric

KW - Outcomes

KW - Pectus excavatum

UR - http://www.scopus.com/inward/record.url?scp=84939969358&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939969358&partnerID=8YFLogxK

U2 - 10.1007/s00383-015-3694-z

DO - 10.1007/s00383-015-3694-z

M3 - Article

C2 - 25814003

AN - SCOPUS:84939969358

VL - 31

SP - 493

EP - 499

JO - Pediatric Surgery International

JF - Pediatric Surgery International

SN - 0179-0358

IS - 5

ER -