Surgeons in surgery room

Surgical risks

The correction of a Pectus Excavatum or Poland Syndrome using a custom-made implant, performed mainly for morphological reasons, remains nevertheless a true surgical intervention, which involves risks associated to any medical procedure, however slight it may be.

In practice, the vast majority of Pectus Excavatum or Poland Syndrome corrections using custom-made implants, performed according to the rules, do not present any serious issue. Postoperative outcomes are simple and most of the patients are totally satisfied with their results. Nevertheless, complications can occur following the intervention, some are inherent to the surgical procedure, and others are specifically related to implants. Complications should be associated to the anaesthesia or to the surgical procedure and other may be linked to the implant.

Complications associated to the anaesthesia 

It should be pointed out that the anaesthesia induces reactions in the body which can sometimes be unpredictable and more or less easy to control. However, with a qualified anaesthesiologist-resuscitator, who practises in an actual surgical situation, the risks incurred become very low. It is necessary to bear in mind that techniques, anaesthetics, and monitoring methods have greatly improved over the past thirty years, offering an optimal safety.

In any case, during the obligatory preoperative consultation, the anaesthesiologist doctor will inform the patient of the anaesthetic risks himself.

 

Complications inherent to the surgical procedure

Surgeon operating

  • Serous effusion ;: This is not a complication since it is steady but transient. It requires 2 to 5 postoperative punctures with 8-day intervals.

  • Haematoma : The excess of blood around the prosthesis is an early complication which can occur during the first hours. If the haematoma is major, revision surgery in the OR is thus preferable in order to evacuate the blood and to stop the bleeding at its origin; it is very exceptional.

  • Infections : Not described to this day after this type of surgery. A deterrent antibiotic therapy is always prescribed during the intervention; it is not recommended after though

  • Cutaneous necrosis : It was observed on the suture line after an inopportune contact of the skin with the electrode of the electric scalpel. Then, a revision surgery is necessary, with the risk to remove temporarily the implant.

  • Healing abnormalities : Since the healing process involves somewhat random phenomena, sometimes scars are not, in the end, as discreet as desired. This eventuality is rare.

  • Sensitivity modification : The anaesthesia of the cutaneous area covering the implant is steady but regresses spontaneously in a centripetal manner in a few months.

  • Pneumothorax : Not described to this day, it would require a specific treatment.

  • Malposition, displacement : Malposition or secondary displacement of implants is avoided respecting rigorously the surgical technique of retro-musculoaponeurotic installation and the choice of a custom-made computer-assisted conception.
 

Risks specifically related to custom-made silicone elastomer implants

They are non-existent, instead of flexible silicone gel breast implants:

  • No folding or wavy aspect
  • No capsula retraction
  • No rupture: the implant is retained for the rest of the patients’ life
  • No long-term late periprosthetic seroma.
  • No risk of lymphoma described recently for certain macro-textured breast implants (smooth silicone elastomer)

Pectus Excavatum

Poland Syndrome