{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T02:31:50Z","timestamp":1770690710080,"version":"3.49.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Minimally invasive repair of pectus excavatum (MIRPE) is the most popular surgical approach for paediatric patients with pectus excavatum. A substernal stainless still bar is inserted and left in place for 3\u2009years and then removed. Our goal was to investigate blood metal levels after MIRPE and to correlate them with surgical details, such as the numbers of bars and stabilizers and the length of time the bar was in place.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Blood levels of iron, chromium, manganese, molybdenum and nickel were analysed in 130 teenagers (108 boys and 22 girls) who had MIRPE using inductively coupled plasma mass spectrometry. A total of 62 patients were operated on using MIRPE (study group) and 68 patients were evaluated at implant time (control group). Differences between the numbers of bars implanted and the presence or absence of stabilizers were also considered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Significant increases in the levels of abnormal chromium were found in patients in the study group compared with the controls (P\u2009=\u20090.02). When we compared the group of patients with 2 or more bars with the group with 1\u2009bar, the percentage of patients with a value above the threshold increased by 29 (P\u2009=\u20090.05). A significant increase in chromium levels was observed in patients with stabilizers (P\u2009=\u20090.03). Above-threshold levels of molybdenum were found in 5.1% of patients in the control group, but the number was not statistically significant (P\u2009=\u20090.09).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>We demonstrated that stainless steel devices used in MIRPE can elevate blood metal levels in paediatric patients. Moreover, we demonstrated that the use of metal stabilizers is associated with higher metal levels, probably due to increased dispersion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivab052","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T04:27:48Z","timestamp":1612412868000},"page":"76-81","source":"Crossref","is-referenced-by-count":5,"title":["Blood metal levels after minimally invasive repair of pectus excavatum"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5197-4380","authenticated-orcid":false,"given":"Michele","family":"Torre","sequence":"first","affiliation":[{"name":"Pediatric Thoracic and Airway Surgery Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy"},{"name":"Department of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Genova Gaia","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Grazia","family":"Calevo","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Raso","sequence":"additional","affiliation":[{"name":"Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Department PROMISE, University Palermo, Palermo, 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