Morphometric changes in the chest after surgical narrowing of the waist using the Kudzaev method

Objective. A new technique for waist narrowing by means of osteotomy and osteoclasia of lower ribs followed by fixation in a tightening thoracolumbar corset was proposed and patented in 2017. The preliminary results showed its high efficiency and safety, but data on the morphological changes in ribs and in chest in general have not yet been published.

The purpose of this study was to analyze changes in the chest in patients after waist narrowing using computed tomography (CT).

Material and methods. 57 waist narrowing surgeries were performed in the period of 2017–2020. All patients were female, mean age (35.6 ± 5.0) years old. Of the 57 patients, 21 underwent chest computed tomography before and 3 months after the surgery. The remaining 36 patients did not undergo CT for various reasons. Based on the CT data, a retrospective study was performed. We compared the inner and outer diameter of the chest at the level of the 10^th rib before and after the surgery and compared these data with changes in waist circumference.

Results. The mean preoperative value of the internal diameter of the chest was (25.3 ± 2.1) cm, after surgery this measure decreased to (22.9 ± 2.7) cm, and the mean difference was (2.4 ± 1.0) cm (9.6%). The average outer diameter (from skin to skin) decreased from preoperative (29.0 ± 0.8) cm to (26.0 ± 1.9) cm (10.1%). At the same time, waist circumference decreased by (8.4 ± 3.5) cm from an average of 73.1 ± 4.7 to (64.7 ± 4.4) cm (11.1%). In 18 out of 21 cases, a complete union of the ribs was observed, in 3 patients there was atrophic non-union with no changes in the waist circumference.

Conclusion. The analysis showed that after the waist narrowing surgery 85.7% of the osteotomized ribs united. It led to an irreversible changes in the diameter of the lower part of the chest and thus to a persistent decrease in waist circumference.

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