Abstract：
Pectus excavatum is the most common congenital anterior chest wall deformity. Currently, a wide variety of diagnostic protocols and criteria for corrective surgery are being used. Their use is predominantly based on local preferences and experience. To date, no guideline is available, introducing heterogeneity of care as observed in current daily practice. The aim of this study was to evaluate consensus and controversies regarding the diagnostic protocol, indications for surgical correction, and postoperative evaluation of pectus excavatum.
The study consisted of 3 consecutive survey rounds evaluating agreement on different statements regarding pectus excavatum care. Consensus was achieved if at least 70% of participants provided a concurring opinion.
All 3 rounds were completed by 57 participants (18% response rate). Consensus was achieved on 18 of 62 statements (29%). Regarding the diagnostic protocol, participants agreed to routinely include conventional photography. In the presence of cardiac impairment, electrocardiography and echocardiography were indicated. Upon suspicion of pulmonary impairment, spirometry was recommended. In addition, consensus was reached on the indications for corrective surgery, including symptomatic pectus excavatum and progression. Participants moreover agreed that a plain chest radiograph must be acquired directly after surgery, whereas conventional photography and physical examination should both be part of routine postoperative follow-up.
Through a multiround survey, international consensus was formed on multiple topics to aid standardization of pectus excavatum care.
The study consisted of 3 consecutive survey rounds evaluating agreement on different statements regarding pectus excavatum care. Consensus was achieved if at least 70% of participants provided a concurring opinion.
All 3 rounds were completed by 57 participants (18% response rate). Consensus was achieved on 18 of 62 statements (29%). Regarding the diagnostic protocol, participants agreed to routinely include conventional photography. In the presence of cardiac impairment, electrocardiography and echocardiography were indicated. Upon suspicion of pulmonary impairment, spirometry was recommended. In addition, consensus was reached on the indications for corrective surgery, including symptomatic pectus excavatum and progression. Participants moreover agreed that a plain chest radiograph must be acquired directly after surgery, whereas conventional photography and physical examination should both be part of routine postoperative follow-up.
Through a multiround survey, international consensus was formed on multiple topics to aid standardization of pectus excavatum care.
摘要：
背景：漏斗胸畸形是最常见的先天性前胸壁畸形。目前,目前正在使用多种矫正手术的诊断方案和标准.它们的使用主要基于当地的偏好和经验。迄今为止,没有可用的指导方针，引入目前日常实践中观察到的护理异质性。这项研究的目的是评估关于诊断方案的共识和争议，手术矫正的适应症，漏斗胸的术后评价。
方法：该研究包括连续3轮调查，评估关于漏斗胸护理的不同陈述的一致性。如果至少有70％的参与者提出了同意的意见，就达成了共识。
结果：所有3轮均由57名参与者完成（应答率为18％）。在62份声明中，有18份（29%）达成了共识。关于诊断方案，参与者同意常规摄影。在心脏受损的情况下，心电图和超声心动图显示。怀疑肺损伤,建议进行肺活量测定.此外,就矫正手术的适应症达成共识，包括有症状的漏斗胸和进展。此外，参与者同意必须在手术后直接获取胸部X光片，而常规摄影和体格检查都应该是常规术后随访的一部分。
结论：通过多轮调查，在多个主题上形成了国际共识，以帮助漏斗胸护理的标准化。
方法：该研究包括连续3轮调查，评估关于漏斗胸护理的不同陈述的一致性。如果至少有70％的参与者提出了同意的意见，就达成了共识。
结果：所有3轮均由57名参与者完成（应答率为18％）。在62份声明中，有18份（29%）达成了共识。关于诊断方案，参与者同意常规摄影。在心脏受损的情况下，心电图和超声心动图显示。怀疑肺损伤,建议进行肺活量测定.此外,就矫正手术的适应症达成共识，包括有症状的漏斗胸和进展。此外，参与者同意必须在手术后直接获取胸部X光片，而常规摄影和体格检查都应该是常规术后随访的一部分。
结论：通过多轮调查，在多个主题上形成了国际共识，以帮助漏斗胸护理的标准化。
