台灣漏斗胸(凹胸)病友協會

最近海外保險公司為了一位澳門病友的理陪申請，與我爭執是否所有漏斗胸都是先天性(congenital)的問題。別的保險公司都有理陪, 只有他們對這有疑問.

不論我如何說明，他們仍堅持許多論文及醫學教科書上的一句話"Pectus is the most common congenital chest wall deformity". 其實, 這是有緣由的. 當我把這問題放到CWIG論壇上, Dr. Nuss立即回復了:

10/25/2017, 15:52 - Donald Donald Nuss MD
Shamberger stated that all pectus excavatum patients were congenital but he and his colleagues (Welch and Ravitch) advocated operating on children before school age so that is why they only saw very young patients. Our experience is somewhat different. Of the 4,000 patients referred to our chest wall clinic only 8.36% were less than 5 years of age and only 13% were under 10 years of age and 80% were teenagers or older. The mean age of the entire group is 15years. The older patients almost always stated that their chest started to cave in and progress rapidly as they started and progressed through puberty. Reference: Pectus excavatum from a pediatric surgeon's perspective. Nuss D, Obermeyer R, Kelly REjr in Annals of Cardiothoracic Surgery Vol 5, No 5,September 2016.

大部的病人的凹胸情況, 是成長後才發生, 只因最早治療漏斗胸的Ravitch 及 Welch 二位前輩發表了幼兒手術經驗時, 用了這一句話, 從此被當成金科玉律, 在論文中一再沿用, 才造成大家的誤解. 

漏斗胸, 可為先天性, 也可能是後天的.