{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T11:20:01Z","timestamp":1761218401888},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund Die Trichterbrust ist eine angeborene Deformit\u00e4t des Thoraxskeletts, bei der das Sternum und die angrenzenden Rippen trichterf\u00f6rmig in Richtung Wirbels\u00e4ule einsinken. Die\n\t\t\t\t\tPathogenese ist bisher nicht eindeutig gekl\u00e4rt. Es gibt verschiedene Therapieans\u00e4tze, von konservativen Ma\u00dfnahmen \u00fcber minimalinvasive Eingriffe bis hin zur offenen Korrektur-OP. Die\n\t\t\t\t\tbetroffenen Patienten leiden unter der \u00e4sthetischen Beeintr\u00e4chtigung sowie kardiopulmonalen Einschr\u00e4nkungen durch die Einengung des Mediastinalraumes. Die Indikationsstellung zur\n\t\t\t\t\tTrichterbrust-Korrektur-OP unterliegt funktionellen und \u00e4sthetischen Gr\u00fcnden.<\/jats:p><jats:p>\n          Patienten Wir berichten \u00fcber einen 23-j\u00e4hrigen m\u00e4nnlichen Patienten mit einer subjektiv beeintr\u00e4chtigenden und objektiv m\u00e4\u00dfiggradigen Trichterbrust. Pr\u00e4operativ wurde ein CT des\n\t\t\t\t\tThorax angefertigt. Der sternovertebrale Abstand betrug 8\u2009cm, der Thoraxquerdurchmesser 28,9\u2009cm (Haller-Index 3,6). Im pr\u00e4operativen Lungenfunktionstest zeigte sich eine leichte Restriktion.\n\t\t\t\t\tAnamnestisch beschrieb der sonst gesunde Patient Kurzatmigkeit bei st\u00e4rkerer Anstrengung. Die Indikation zur Trichterbrust-Korrektur-OP wurde gestellt. Diese erfolgte in kombinierter\n\t\t\t\t\tOperationstechnik: untere Sternotomie und Knorpelkeilresektion nach Brunner\/Grob sowie Implantation eines Metallb\u00fcgels ohne seitliche Antirotationsplatte. Ein zeitaufwendiger Schritt der OP\n\t\t\t\t\tbesteht in der intraoperativen Anpassung des Metallb\u00fcgels. Daher fertigten wir im Vorfeld der OP anhand des Thorax-CTs eine 3-D-Rekonstruktion des kn\u00f6chernen Thorax mittels 3-D-Drucker an.\n\t\t\t\t\tDer Metallb\u00fcgel wurde daran angepasst und im OP eingesetzt. Dies verk\u00fcrzte die Operationsdauer um mindestens 15\u2009min.<\/jats:p><jats:p>\n          Ergebnisse In den postoperativen Nachuntersuchungen zeigten sich ein aufgerichteter Trichter und ein zufriedenstellendes \u00e4sthetisches Ergebnis. Sieben Monate nach Implantation\n\t\t\t\t\terfolgte die planm\u00e4\u00dfige Stabexplantation. Die postoperative CT-Kontrolle ergab nun einen Haller-Index von 3,25, der Lungenfunktionstest eine funktionelle Verbesserung. Subjektiv war der\n\t\t\t\t\tPatient allzeit beschwerdefrei.<\/jats:p><jats:p>\n          Schlussfolgerung Die Implantatanfertigung am 3-D-Modell hilft, OP-Zeit zu sparen. Die Praktikabilit\u00e4t ist noch nicht etabliert, da durch die Erstellung eines 3-D-Modells des\n\t\t\t\t\tkn\u00f6chernen Thorax ein anderweitig h\u00f6herer Aufwand entsteht. Mit zunehmender Digitalisierung der medizinischen Welt ist es jedoch vorstellbar, dass zuk\u00fcnftig die Erstellung von digitalen und\n\t\t\t\t\trealen 3-D-Modellen einfacher und kosteng\u00fcnstiger wird.<\/jats:p>","DOI":"10.1055\/a-1487-7041","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T23:44:06Z","timestamp":1625528646000},"page":"65-73","source":"Crossref","is-referenced-by-count":1,"title":["Trichterbrust-Korrektur-OP unter Zuhilfenahme einer 3-D-Rekonstruktion des Thorax zur pr\u00e4operativen Anpassung des Korrekturstabes"],"prefix":"10.1055","volume":"147","author":[{"given":"Catharina","family":"Scheuermann-Poley","sequence":"additional","affiliation":[{"name":"Orthop\u00e4die\/Unfallchirurgie, Thoraxchirurgie, septisch-rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian Martin","family":"Andre\u00df","sequence":"additional","affiliation":[{"name":"Allgemeine, Unfall- und Wiederherstellungschirurgie, LMU, M\u00fcnchen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Willy","sequence":"additional","affiliation":[{"name":"Orthop\u00e4die\/Unfallchirurgie, Thoraxchirurgie, septisch-rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Lieber","sequence":"additional","affiliation":[{"name":"Orthop\u00e4die\/Unfallchirurgie, Thoraxchirurgie, septisch-rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1093\/icvts\/ivs045","article-title":"Pectus excavatum: history, hypotheses and treatment options","volume":"14","author":"C Brochhausen","year":"2012","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"04","key":"ref2","first-page":"49","article-title":"Trichterbrust, Operationsindikation und OP-Verfahren","author":"A Lieber","year":"2003","journal-title":"Wehrmed Wehrpharm"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/s0003-4975(10)64129-x","article-title":"Repair of pectus excavatum in children under 3 years of age: a twelve-year experience","volume":"23","author":"M M Ravitch","year":"1977","journal-title":"Ann Thorac Surg"},{"key":"ref4","first-page":"50","article-title":"Congenital malformation of the thorax, great depression of the sternum","volume":"24","author":"C T Williams","year":"1872","journal-title":"Trans Path Soc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1055\/s-0028-1101265","article-title":"Experiences with the surgical treatment of funnel chest","volume":"14","author":"H Kunz","year":"1966","journal-title":"Thoraxchir Vask Chir"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/S0096-5588(20)32033-X","article-title":"Pectus excavatum (funnel chest)","volume":"9","author":"A L Brown","year":"1939","journal-title":"J Thorac Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1097\/00000658-194406000-00012","article-title":"Pectus excavatum: report of two cases successfully operated upon","volume":"119","author":"R H Sweet","year":"1944","journal-title":"Ann Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1055\/s-0030-1250602","article-title":"Surgical correction of pectus excavatum. 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