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Journal of Indian Association of Pediatric Surgeons
Medknow Publications on behalf of the Indian Association of Pediatric Surgeons
ISSN: 0971-9261 EISSN: 1998-3891
Vol. 10, Num. 3, 2005, pp. 157-157

Journal of Indian Association of Pediatric Surgeons, Vol. 10, No. 3, July-September, 2005, pp. 157

Editorial Comment

Editorial comments

Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
Correspondence Address:Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029, Email: devendra6@hotmail.com

Code Number: ip05038

Related article: ip05037

The writer of the review article on ′Chest Wall Deformities′ is an internationally renowned pediatric surgeon with varying clinical and research interests, obtained mainly from Europe and the United states. The author has covered the vast subject very lucidly providing general information on the subject and incorporating the most recent advances in the field including the long-term results. It is a well-known fact that chest wall deformities, especially the pectus excavatum are frequently seen in the Western world, each major center having sufficient case material each year. Apart from the general awareness amongst the children and the parents, the incidence is truly high, and possibly genetic.

In India or rather amongst the Asian countries, the incidence of pectus deformities is much less. Also, the importance and awareness is much less as the exposures of the chest due to the sports activity and at the beach are less common in this sub-continent. Also, it is quite possible that the minor defects are frequently missed and not reported by the parents. However, the incidence of major defects requiring surgical intervention is definitely less common in India. There are only a few Institutions that would perform surgery for pectus deformities in children and still, not more than a few cases would be operated upon each year even in the tertiary care level institutions. It is also interesting that of the major chest wall deformities seen during the past two decades in the department of pediatric surgery at AIIMS, New Delhi, more than 50% of infants and children had associated, underlying chest pathology (lung cysts, gastroesophageal reflux, congenital heart defect, lobaremphysema). Recurrent chest infection is the main presentation. The symptoms get worsened with little exertion or chest infection, especially in the winter season. Surgical approach is still the main stay in this part of world. The Nuss procedure that has become the procedure of choice in the West in the recent past, is yet to be accepted in this part of the world, not only due to the rarity of defects seen but also due to the cost factor of the instruments.

I am sure the readers would enjoy the subject from the pen of the expert.

Copyright 2005 - Journal of Indian Association of Pediatric Surgeons

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