2023 Fiscal Year Final Research Report

Construction of a classification system for pectus excavatum morphology based on image data analysis and development of a new surgical support system

Research Project

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Project/Area Number	21K08627
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 55010:General surgery and pediatric surgery-related
Research Institution	Keio University
Principal Investigator	Kyohei Masai 慶應義塾大学, 医学部(信濃町), 講師 (70778290)
Co-Investigator(Kenkyū-buntansha)	鈴木嵩弘慶應義塾大学, 医学部(信濃町), 助教 (50868122) 西田梨紗慶應義塾大学, 医学部(信濃町), 助教 (60896661) 朝倉啓介慶應義塾大学, 医学部(信濃町), 教授 (90383786)
Project Period (FY)	2021-04-01 – 2024-03-31
Keywords	漏斗胸 / 画像データ解析 / Nuss法 / バイオメカニクス / CRN法
Outline of Final Research Achievements	The Nuss procedure, which corrects the chest wall using a titanium bar, is commonly utilized for surgical treatment of pectus excavatum. The varied form of pectus excavatum among patients underscores the importance of understanding its characteristics for effective surgical intervention. Factors such as the degree and asymmetry of the depression, as well as bone sclerosis associated with age, contribute to the complexity of pectus excavatum surgery. Through objective analysis of pectus excavatum morphology via image analysis, we have identified challenges with the Nuss procedure. As a result, we have developed a new surgical approach, the Combined Ravitch and Nuss Procedure (CRN procedure), which integrates the Nuss and Ravitch procedures as an innovative treatment method ready for clinical practice.
Free Research Field	呼吸器外科
Academic Significance and Societal Importance of the Research Achievements	これまで漏斗胸は小児先天性疾患とされ、疾患対象が小児・思春期の患者であったが、われわれの研究発表によって成人漏斗胸患者が一定頻度存在し治療介入の必要性があること、その臨床特徴や治療における問題点が少しずつ解明されるようになった。成人漏斗胸の病態解明や治療法を明らかにすることは学術的・社会的にも非常に意義のあることであると考える。今回の研究を行うにあたり成人漏斗胸患者の手術は骨硬化が強く胸郭挙上が不十分になりやすい点や慢性疼痛の問題などいくつかの問題点が分かってきた。今後は更なる研究を重ね学術的に意義のある研究結果を報告する予定である。