Evaluation of pectus bar position and osseous XXXX .

@entity1 @entity79 @entity1408 @entity190
PURPOSE: Minimally invasive repair has become a popular approach for @entity1408 ( @entity1408 ). The bar is secured to the thoracic wall and left for approximately 2 years. The authors have noticed an intense @entity79 ( @entity79 ) around some of these bars at removal. A review of @entity1 undergoing bar removal was performed to better understand this @entity79 in relation to bar placement. METHODS: A retrospective review of @entity1 undergoing bar removal after @entity1408 repair since January 1998 was performed. Chart review included age at bar insertion and removal, bar insertion position (subcutaneous [SC] v submuscular [SM]), @entity79 on Chest x-ray and at bar removal, operating time, and estimated @entity190 (EBL). RESULTS: Thirty-six @entity1 underwent bar removal during the study period (16 SC and 20 SM). Chest x-ray evaluation was possible in 27 @entity1 (16 SM, 11 SC). No difference existed for length of time the bar was in place or age at insertion/removal between groups. EBL was higher in the SM (18.3 v 8.8 mL, not significant). @entity79 was seen radiographically in 15 SM and 3 SC @entity1 (P <.001). @entity79 was encountered at removal in 19 SM @entity1 and a single SC @entity1 (P <.001). Operating time was statistically longer (P <.01) for the SM group (30.2 v 15.6 min). CONCLUSIONS: Bar position during repair of @entity1408 is important. SM positioning virtually always results in @entity79 with increased EBL and statistically longer operating time at removal. Careful placement of the bar in the SC position without violating the fascia should be used to avoid these undesirable effects.
