Barrel chest is a relatively common chest wall deformity characterized by the overall convexity of the anterior chest wall, with increased anterior-posterior diameters. Notably, the anterior-posterior diameter nearly equals the left-right diameter, giving the chest a barrel-shaped appearance. In addition, there is a decrease in the inclination of the ribs, with the angle between the ribs and spine often exceeding 45 degrees. The intercostal spaces widen significantly, and the infrasternal angle enlarges.
Introduction
Causes
The cause of primary barrel chest remains unclear, but it typically develops from an early age. Secondary barrel chest, on the other hand, is often caused by chronic respiratory diseases such as emphysema. It may also arise from thoracic, pleural, and cardiovascular diseases, as well as some other factors.
Symptoms
Patients with primary barrel chest generally do not exhibit noticeable symptoms. However, those with secondary barrel chest often have significant respiratory symptoms due to the underlying disease, such as coughing, hemoptysis, chest pain, chest tightness, shortness of breath, and breathing difficulty.
Diagnostic Methods
Diagnosis primarily involves a physical examination by observing the appearance of the chest wall, supplemented by imaging examination such as X-ray, chest CT scan, and 3D reconstruction imaging.
Surgical Procedures
This new generation minimally invasive procedure is specifically designed for protrusion deformity and is ideal for treating barrel chest. The procedure incorporates various innovative techniques to ensure safety and simplicity in execution, greatly minimizing trauma while achieving satisfactory correction results.
Frequently Asked Questions
Typically, 2 small incisions are made, one on each side of the chest.
In most cases, 3 bars are sufficient to achieve correction. However, for patients with excessive height, a more severe deformity, or additional abnormalities (such as rib flare or concave deformity), four bars may be necessary.
In most cases, the deformity is significantly corrected right after the procedure, resulting in a chest wall that appears close to normal. Following this initial correction, the chest continues a process of slight, gradual remodeling over time. The new contour is typically well-established within about 3 months and fully stabilizes after 2 to 3 years.
In the early postoperative period, changes in chest wall shape alters lung volume, leading to a temporary restriction in pulmonary function. Active respiratory exercise is crucial after surgery. With continued training, pulmonary function typically improves and strengthens progressively.
The total cost usually ranges from $10,000 to $17,000. The exact amount will be determined by factors such as the patient’s condition and the specific surgical plan.
It is common to experience significant pain in the initial postoperative period, particularly among adolescent and adult patients due to their more rigid skeletal structure. Our hospital employs a comprehensive, multi-modal analgesia protocol to ensure effective pain control. This integrated approach includes:
- Intraoperative Intervention: Intercostal nerve blocks are administered to prevent pain signals from transmitting.
- Postoperative Medication: Continuous pain management is delivered through a patient-controlled analgesia (PCA) pump, supplemented with scheduled intravenous analgesics.
- Adjunctive Rehabilitation Therapy: Our dedicated rehabilitation team provides personalized physiotherapy, incorporating techniques such as acupuncture, therapeutic massage, electrical stimulation, and ultrasound therapy. These modalities are highly effective in alleviating localized pain and common discomforts like postoperative bloating.
Most patients stay in the hospital for 7 - 14 days, although the actual duration depends on individual recovery.
The risk is very low. The bars used in surgery are made of titanium alloy, which provides excellent rigidity and resistance to deformation. In addition, the Wang Technique, a cutting-edge bar fixation method, is utilized during surgery to rigidly stabilize the bars in position, effectively preventing movement. Long-term clinical data confirms that the vast majority of patients do not experience bar displacement or deformation. It is crucial to note that during the early postoperative period (within the first 3 months), patients should avoid vigorous exercise and be mindful in their daily lives to avoid significant impact or trauma to the chest, thereby reducing the likelihood of bar displacement.
Most patients can get out of bed and walk within 3–4 days after surgery, and resume daily activities around 10 days postoperatively. Patients can usually return to normal work or school (excluding heavy physical labor) around 1 month. Light exercise, such as jogging or hiking, can start within the first three months, with intensity gradually increased thereafter.
It is crucial to note that if you encounter any discomfort, such as chest pain or shortness of breath, during exercise, you should stop the activity immediately. If necessary, a chest X - ray or CT scan can be arranged for further examination.
Yes, for the initial postoperative period, maintaining a specific sleeping position is important for healing. It is advised to sleep in a supine position (lying on your back) or a modified lateral position (partially reclining on one side) for the first month , adjusting as needed for comfort around the incision sites. Additionally, you need to avoid movements with a large range of motion, like chest expansion, bending over, and lifting heavy objects. After about a month, once your incisions have completely healed, you can gradually start sleeping on your side.
After the drainage tubes are removed (the removal time is determined by the drainage volume and follow - up examination results, generally within 1 - 2 weeks), you can take a shower with the wound covered by waterproof dressings. After finishing the shower, replace the dressings with breathable gauze to protect the wound. Around 3 weeks after surgery, once the incisions have completely healed, you can take a normal shower.
Our discharge protocol is designed to ensure your safety. Typically, patients can be safely discharged 7 - 10 days post-surgery. After continuing to observe for about one week post - discharge, the risk of the vast majority of complications can generally be excluded. If recovery progresses smoothly during the first three weeks post-surgery, the likelihood of later complications is extremely low. Additionally, the bars are firmly secured, and the surgical technique is specifically designed to prevent issues like bar displacement.
However, if you notice symptoms such as pneumothorax, pleural effusion, significant pain, or poor wound healing, please contact our doctors promptly. In case of an emergency, please seek immediate care at a local hospital.
If your recovery goes well without any noticeable discomfort or abnormal conditions, regular follow-up is usually not required. However, if you develop symptoms such as persistent high fever (temperature >38.5°C), sudden chest tightness, shortness of breath, or difficulty breathing, please have a chest X-ray or CT scan locally and consult a thoracic surgeon or our doctor for further guidance.
The bars are usually removed about three years after surgery, with the exact timing determined by the patient’s recovery and the doctor’s evaluation.
Yes. Upon discharge, we will provide a discharge summary and a medical certificate. If airport security raises any concerns, presenting these medical documents will facilitate your passage.
In most cases, taking a flight does not cause discomfort, you can travel with confidence.
Optimal nutrition is crucial for healing. We recommend the following dietary plan, tailored to your recovery phase:
Initial Phase (during bed rest): Choose easily digestible semi-liquid foods, such as porridge, juice, or well-cooked noodles.
Recovery Phase (once able to get out of bed): Gradually resume a normal, balanced diet with an emphasis on high-quality protein sources such as fish, chicken, and eggs. Make sure to eat fresh fruits and vegetables daily to supplement vitamins and electrolytes.
Precautions: Strictly avoid spicy and greasy foods, and be cautious with foods that may trigger allergies, such as seafood or mangoes.
