D21. Approach to the Pediatric Poland Syndrome Patient: A 20-year Academic Experience and Update of the Literature

PURPOSE: Poland Syndrome is a congenital deformity of heterogenous presentations such as syndactyly, hypoplasia or aplasia of the pectoralis muscles, and malformation of the breast. Due to the broad presentation of symptomologies, diagnosis and treatment of Poland Syndrome remains challenging. To streamline the diagnosis workflow, we propose a novel classification schema for diagnosis in this study and compared its patient management outcomes with a conventional classification system. METHODS: A retrospective study of patients diagnosed with Poland Syndrome was performed over a 21-year period. Patient demographics, surgical history, and perioperative complications were recorded. Surgical interventions were compared between Foucras Classification schema and our novel schema. RESULTS: A total of 97 patients were included, 50 (51.5%) of whom underwent initial surgery. A novel Poland classification system is proposed based on patient presentation. Surgical Trends differed between classification schemas: A higher Foucras Classification was not associated with having any surgical intervention (p=0.36), but a higher Poland Class in our schema was associated with having surgical intervention (p<0.001). Most patients who had latissimus flaps (79%) were classified as Type 1a in our schema (p<0.001). Patients who had latissimus flaps were not significantly associated with a given Foucras Classification (p=0.80). CONCLUSION: Both the Poland Class and Foucras Classification provide valuable ways of stratifying pediatric Poland Syndrome patients and may help guide surgical decision making for future patients.