Journal of pediatric surgery · 2026
Bridge fixation provides consistent implant stability across surgical techniques: A multicenter study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Toselli Luzia, Bellia-Munzón Gastón, Vega Carla, Giacosa Facundo, Sanjurjo Daniela, Pintos Gastón, Elmo Gastón, Fernández Melissa, Siscar Natalia, Nicolás Matías, Carmona Alejandro, Martínez-Ferro Marcelo
Аннотация
BACKGROUND/PURPOSE: Bar rotation remains a relevant complication following minimally invasive repair of pectus excavatum (MIRPE), with potential need for reoperation and risk of severe intrathoracic injury. Bridge fixation has been proposed as a stabilization strategy to prevent implant rotation; however, evidence supporting its effectiveness remains limited. This study aimed to evaluate the stability of bridge fixation in a large multicenter cohort.
METHODS: A retrospective multicenter study was conducted including patients undergoing chest wall repair with intrathoracic implants stabilized using bilateral lateral bridges across five centers in Buenos Aires, Argentina, between November 2015 and November 2025. Demographic characteristics, surgical technique, implant configuration, use of cryoanalgesia, postoperative length of stay, complications, and implant removal were collected. The primary outcome was reoperation due to implant rotation.
RESULTS: A total of 1821 intrathoracic implants were placed in 710 patients. Median age was 15.0 years (IQR 14.0; 17.0; range 9-52), with 174 patients (24.6%) older than 17 years. Most procedures were MIRPE (92.5%), followed by the sandwich technique (3.9%) and hybrid techniques (3.5%). Two bars were used in 44.4% of patients and three bars in 54.9%. Crossed bars were used in 31.0% of cases, and cryoanalgesia was used in 68.6% of patients. Implant removal was performed in 52.0% of patients at a median of 24.0 months (IQR 23.0; 25.0). Overall, postoperative complications requiring reoperations occurred in 6.1% of patients. No implant rotation requiring reoperation was observed among the 1821 implants during the study period.
CONCLUSIONS: In this large multicenter series, bridge fixation was associated with complete prevention of implant rotation requiring reoperation across a wide range of surgical techniques, implant configurations, and patient characteristics. These findings support the reliability of the bridge technique to prevent implant rotation.
TYPE OF STUDY: Treatment study.
LEVEL OF EVIDENCE: IV.
METHODS: A retrospective multicenter study was conducted including patients undergoing chest wall repair with intrathoracic implants stabilized using bilateral lateral bridges across five centers in Buenos Aires, Argentina, between November 2015 and November 2025. Demographic characteristics, surgical technique, implant configuration, use of cryoanalgesia, postoperative length of stay, complications, and implant removal were collected. The primary outcome was reoperation due to implant rotation.
RESULTS: A total of 1821 intrathoracic implants were placed in 710 patients. Median age was 15.0 years (IQR 14.0; 17.0; range 9-52), with 174 patients (24.6%) older than 17 years. Most procedures were MIRPE (92.5%), followed by the sandwich technique (3.9%) and hybrid techniques (3.5%). Two bars were used in 44.4% of patients and three bars in 54.9%. Crossed bars were used in 31.0% of cases, and cryoanalgesia was used in 68.6% of patients. Implant removal was performed in 52.0% of patients at a median of 24.0 months (IQR 23.0; 25.0). Overall, postoperative complications requiring reoperations occurred in 6.1% of patients. No implant rotation requiring reoperation was observed among the 1821 implants during the study period.
CONCLUSIONS: In this large multicenter series, bridge fixation was associated with complete prevention of implant rotation requiring reoperation across a wide range of surgical techniques, implant configurations, and patient characteristics. These findings support the reliability of the bridge technique to prevent implant rotation.
TYPE OF STUDY: Treatment study.
LEVEL OF EVIDENCE: IV.