Stress distribution on the thorax after the Nuss procedure for pectus excavatum results in different patterns between adult and child patients

Tomohisa Nagasao, Junpei Miyamoto, Tamotsu Tamaki, Kazuhiko Ichihara, Hua Jiang, Toshihiko Taguchi, Ryohei Yozu, Tatsuo Nakajima

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective: In the Nuss procedure, in which the deformed thorax is forcibly corrected by insertion of correction bars, considerable stresses occur on the patient's thorax. We performed the present study to elucidate how stress patterns on the thorax after this procedure differ between child and adult patients. Methods: Eighteen patients with pectus excavatum, constituting a child group (n = 10) and an adult group (n = 8), were included in the study. After a 3-dimensional computer-assisted design model was produced with computed tomographic data from each patient, simulation of the Nuss procedure was performed on the model. Then the stresses occurring on each thorax were calculated using the finite element method. The stresses were compared between the child and adult groups in terms of intensity on each rib and the distribution patterns over the whole thorax. Results: With all 12 ribs, significantly greater stress occurred in the adult group than stress in the child group. Although the stresses occurring on the thorax demonstrated concentrated patterns in the child group, widely distributed patterns were observed in the adult group. Conclusions: The stresses that occur on the thorax after the Nuss procedure take different patterns between children and adults in terms of intensity and distribution. The differences should be taken into consideration in managing postoperative pain after the Nuss procedure.

Original languageEnglish
Pages (from-to)1502-1507
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume134
Issue number6
DOIs
Publication statusPublished - 2007 Dec

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Funnel Chest
Thorax
Ribs
Patient Simulation
Computer-Aided Design
Postoperative Pain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Stress distribution on the thorax after the Nuss procedure for pectus excavatum results in different patterns between adult and child patients. / Nagasao, Tomohisa; Miyamoto, Junpei; Tamaki, Tamotsu; Ichihara, Kazuhiko; Jiang, Hua; Taguchi, Toshihiko; Yozu, Ryohei; Nakajima, Tatsuo.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 134, No. 6, 12.2007, p. 1502-1507.

Research output: Contribution to journalArticle

Nagasao, Tomohisa ; Miyamoto, Junpei ; Tamaki, Tamotsu ; Ichihara, Kazuhiko ; Jiang, Hua ; Taguchi, Toshihiko ; Yozu, Ryohei ; Nakajima, Tatsuo. / Stress distribution on the thorax after the Nuss procedure for pectus excavatum results in different patterns between adult and child patients. In: Journal of Thoracic and Cardiovascular Surgery. 2007 ; Vol. 134, No. 6. pp. 1502-1507.
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T1 - Stress distribution on the thorax after the Nuss procedure for pectus excavatum results in different patterns between adult and child patients

AU - Nagasao, Tomohisa

AU - Miyamoto, Junpei

AU - Tamaki, Tamotsu

AU - Ichihara, Kazuhiko

AU - Jiang, Hua

AU - Taguchi, Toshihiko

AU - Yozu, Ryohei

AU - Nakajima, Tatsuo

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N2 - Objective: In the Nuss procedure, in which the deformed thorax is forcibly corrected by insertion of correction bars, considerable stresses occur on the patient's thorax. We performed the present study to elucidate how stress patterns on the thorax after this procedure differ between child and adult patients. Methods: Eighteen patients with pectus excavatum, constituting a child group (n = 10) and an adult group (n = 8), were included in the study. After a 3-dimensional computer-assisted design model was produced with computed tomographic data from each patient, simulation of the Nuss procedure was performed on the model. Then the stresses occurring on each thorax were calculated using the finite element method. The stresses were compared between the child and adult groups in terms of intensity on each rib and the distribution patterns over the whole thorax. Results: With all 12 ribs, significantly greater stress occurred in the adult group than stress in the child group. Although the stresses occurring on the thorax demonstrated concentrated patterns in the child group, widely distributed patterns were observed in the adult group. Conclusions: The stresses that occur on the thorax after the Nuss procedure take different patterns between children and adults in terms of intensity and distribution. The differences should be taken into consideration in managing postoperative pain after the Nuss procedure.

AB - Objective: In the Nuss procedure, in which the deformed thorax is forcibly corrected by insertion of correction bars, considerable stresses occur on the patient's thorax. We performed the present study to elucidate how stress patterns on the thorax after this procedure differ between child and adult patients. Methods: Eighteen patients with pectus excavatum, constituting a child group (n = 10) and an adult group (n = 8), were included in the study. After a 3-dimensional computer-assisted design model was produced with computed tomographic data from each patient, simulation of the Nuss procedure was performed on the model. Then the stresses occurring on each thorax were calculated using the finite element method. The stresses were compared between the child and adult groups in terms of intensity on each rib and the distribution patterns over the whole thorax. Results: With all 12 ribs, significantly greater stress occurred in the adult group than stress in the child group. Although the stresses occurring on the thorax demonstrated concentrated patterns in the child group, widely distributed patterns were observed in the adult group. Conclusions: The stresses that occur on the thorax after the Nuss procedure take different patterns between children and adults in terms of intensity and distribution. The differences should be taken into consideration in managing postoperative pain after the Nuss procedure.

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