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@#Objective To assess the efficacy of lymphadenectomy in different regions for esophageal squamous cell carcinomas located differently according to the lymph node grouping by Chinese expert consensus. Methods The medical records of 1 061 patients (886 males and 175 females with a median age of 60 (54, 65) years with esophageal cancer from March 2011 to December 2017 in our hospital were retrospectively analyzed. According to the pathological report, the lymph nodes were regrouped according to the Chinese lymph nodes grouping standard of esophageal cancer. The metastasis rate of each group of lymph nodes, the 5-year survival rate of metastatic patients and efficacy index (EI) were calculated. Results The upper thoracic esophageal cancer mainly metastasized to the lymph nodes of C201-203 groups. The middle and lower thoracic tumors mainly metastasized to the lymph nodes of C205-207 groups. The lower thoracic tumor had a higher rate of metastasis to the abdominal lymph nodes. According to the metastasis rate, the mediastinal lymph nodes were divided into three regions: an upper mediastinum (C201-204), a middle mediastinum (C205-206), and a lower mediastinum (C207-209). The EIs of lymph nodes of C201-203 and C205-207 groups were higher. For patients with C201-207 groups metastasis, the 5-year survival rates ranged from 13.39% to 21.60%. For patients with positive lymph nodes in each region, tumors at different primary locations had no statistical difference in long-term survival (P>0.05). Patients with lymph nodes of C205 group in the upper thoracic tumors had lower EI and those in the middle and lower thoracic tumors had higher EIs. Conclusion The effect of lymph node dissection in each area varies with the location of the tumor. No matter where the tumor is, it is necessary to dissect the upper mediastinal lymph nodes, especially the lymph nodes adjacent to the left and right recurrent laryngeal nerves. Group C205 should be classified into the lower mediastinal lymph nodes.
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@#Objective To evaluate the effect of perioperative nebulization of ipratropium bromide on preoperative pulmonary function and incidence of postoperative pulmonary complications as well as safety in chronic obstructive pulmonary disease (COPD) patients who underwent lung resection in thoracic surgery. Methods During November 18, 2013 to August 12, 2015, 192 COPD patients with a necessity of selective surgical procedures of lobectomy or right bilobectomy or segmentectomy under general anaesthesia in 10 centers were 1 : 1 randomized to an ipratropium bromide group (96 patients) and a placebo group (96 patients), to compare the effect on preoperative pulmonary function and incidence of postoperative pulmonary complications. The average age of treated patients was 62.90±6.50 years, with 168 male patients and 22 female patients. Results The demographic and baseline characteristics were well-balanced between the two groups. The adjusted mean increase of forced expiratory volume in one second (FEV1) in the ipratropium bromide group was significantly higher than that in the placebo group (169.90±29.07 mL vs. 15.00±29.35 mL, P<0.05). The perioperative use of ipratropium bromide significantly decreased incidence of postoperative pneumonia (2.6% vs. 14.1%, P<0.05). There was no ipratropium bromide related adverse event (AE) observed in this trial. Conclusion This trial indicates that perioperative nebulization of ipratropium bromide significantly improves preoperative lung function and reduces postoperative pneumonia in COPD patients undergoing lung resection in thoracic surgery, and has good safety profile.
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Objective:To evaluate the efficacy and safety of ribonucleic acid for injection Ⅱ combined with chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC).Methods:Based on the LinkDoc database, 2 111 patients who were diagnosed with stage Ⅲ B and Ⅳ NSCLC in 8 research centers such as Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2014 to December 2017 were included. Patients were divided into observation group (1 039 cases) and control group (1 072 cases) according to whether or not they had used ribonucleic acid for injection Ⅱ during chemotherapy. Inverse probability of treatment weighting was used to correct the confounding factors of patients, and there were 1 078 cases in the control group and 1 033 cases in the observation group; the overall survival (OS), progression-free survival (PFS) and the occurrence of adverse events and chemotherapy-related adverse reactions were compared between the two groups. Results:The median OS time of the observation group and the control group was 18.51 months and 15.65 months, and the median PFS time was 7.00 months and 5.49 months, and the differences were statistically significant ( P values ??were 0.001 and 0.003). The incidence of adverse events in the observation group was slightly higher than that in the control group [75.6% (781/1 033) vs. 74.1% (799/1 078)], and the incidence of chemotherapy-related adverse reactions in the observation group was slightly higher than that in the control group [43.9% (453/1 033) vs. 40.7% (439/1 078)], but the differences were not statistically significant (both P > 0.05). Conclusions:Ribonucleic acid for injection Ⅱ can prolong the OS and PFS time of patients with stage Ⅲ B and Ⅳ NSCLC receiving chemotherapy. It is safe and can increase the clinical benefit of patients to a certain extent.
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@#Objective To compare the 5-year survival rates between two different follow-up patterns of postoperative stage Ⅰ-ⅢA non-small cell lung cancer (NSCLC) patients. Methods Pathological stage Ⅰ-ⅢA NSCLC 11 958 patients who underwent surgical resection and received follow-up within 6 months after initial diagnosis through telephone follow-up system were included in nine hospitals from July 2014 to July 2020. The patients were divided into two groups including a proactive follow-up group (n=3 825) and a passive follow-up group (n=8 133) according to the way of following-up. There were 6 939 males and 5 019 females aged 59.8±9.5 years. The Kaplan-Meier and Cox proportional hazards regression model were used. Results The median follow-up frequency was 8.0 times in the proactive follow-up group and 7.0 times in the passive follow-up group. The median call duration was 3.77 minutes in the proactive follow-up group and 3.58 minutes in the passive follow-up group. The 5-year survival rate was 81.8% and 74.2% (HR=0.60, 95CI 0.53-0.67, P<0.001) in the proactive follow-up group and the passive follow-up group, respectively. Multivariate analysis showed that follow-up pattern, age, gender and operation mode were independent prognostic factors, and the results were consistent in all subgroups stratified by clinical stages. Conclusion The proactive follow-up leads to better overall survival for resected stage Ⅰ-ⅢA NSCLC patients, especially in the stage ⅢA.
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To investigate the computed tomographc(CT)features of mild/moderate and severe/critical cases of coronavirus disease 2019(COVID-19)in the recovery phase. Totally 63 discharged patients in Wuhan,China,who underwent both chest CT and reverse transcription-polymerase chain reaction(RT-PCR)from February 1 to February 29,2020,were included.With RT-PCR as a gold standard,the performance of chest CT in diagnosing COVID-19 was assessed.Patients were divided into mild/moderate and severe/critical groups according to the disease conditions,and clinical features such as sex,age,symptoms,hospital stay,comorbidities,and oxygen therapy were collected.CT images in the recovery phase were reviewed in terms of time from onset,CT features,location of lesions,lobe score,and total CT score. There were 37 patients in the mild/moderate group and 26 in the severe/critical group. Compared with the mild/moderate patients,the severe/critical patients had older age [(43±16) years (52±16) years; =2.10, =0.040], longer hospital stay [(15±6)d (19±7)d; =2.70, =0.009], higher dyspnea ratio (5.41% 53.85%; =18.90, <0.001), lower nasal oxygen therapy ratio (81.08% 19.23%;=23.66, <0.001), and higher bi-level positive airway pressure ventilation ratio (0 57.69%; =25.62, <0.001). Time from onset was (23±6) days in severe/critical group, significantly longer than that in mild/moderate group [(18±7) days] (=3.40, <0.001). Severe/critical patients had significantly higher crazy-paving pattern ratio (46.15% 10.81%;=4.24, =0.039) and lower ground-glass opacities ratio (15.38% 67.57%; =16.74, <0.001) than the mild/moderate patients. The proportion of lesions in peripheral lung was significantly higher in mild/moderate group than in severe/critical group (78.38% 34.61%; =13.43, <0.001), and the proportion of diffusely distributed lesions was significantly higher in severe/critical group than in mild/moderate group (65.38% 10.81%; =20.47, <0.001). Total CT score in severe/critical group was also significantly higher in severe/critical group than in mild/moderate group [11 (8,17) points 7 (4,9) points; =3.81, <0.001]. The CT features in the recovery stage differ between mild/moderate and severe/critical COVID-19 patients.The lung infiltration is remarkably more severe in the latter.
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Adult , Aged , Humans , Middle Aged , Betacoronavirus , China , Coronavirus Infections , Diagnostic Imaging , Pandemics , Pneumonia, Viral , Diagnostic Imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
@#Objective To explore the safety and feasibility of the application of video-assisted thoracic surgery (VATS) anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis. Methods From June 2014 to June 2018, 19 patients with bilateral localized bronchiectasis underwent single-stage bilateral thoracic surgery with VATS anatomic segmentectomy, including 11 males and 8 females aged 38.0±12.5 years. The clinical efficacy of the surgery was evaluated. Results All surgeries were successfully completed, of which 17 were bilateral VATS, 2 were unilateral VATS with the other lateral converted to thoracotomy. The average number of bilateral resected segments was 4-8 (5.9±1.2). Mean operation time was 330.0±40.0 min and mean blood loss was 150.0±60.0 mL. Mean ventilator-assisted breathing time was 6.0±1.8 h, mean duration of chest-tube placement was 4.0±1.0 d and mean hospital stay time was 14.0±1.5 d. Three patients suffered pulmonary infection and 1 patient received tracheotomy. No perioperative death occurred. Arterial oxygen pressures on postoperative day (POD) 1 (F=340.18, P<0.05) and POD 3 (F=131.26, P<0.05) were significantly lower than that before operation, arterial carbon dioxide pressures on POD 1 (F=46.62, P<0.05) and POD 3 (F=48.21, P<0.05) were significantly higher than that before operation, and pulse oximeter saturation on POD 1 was significantly lower than that before operation (F=210.82, P<0.05). The patients were followed up for one to five years without recurrence. Conclusion Application of VATS anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis is safe and feasible with strictly selected patients. Postoperative airway management is very important. The surgery is worthy of wide clinical practice.
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Objective:The clinical characteristics of critical COVID-19 patients with pneumothorax after mechanical ventilation were retrospectively analyzed to provide reference for epidemic prevention and treatment.Methods:A retrospective analysis was made on 130 cases of COVID-19 critically patients admitted from January 1, 2020 to February 13, 2020 in Jinyintan Hospital of Wuhan.The clinical characteristics, mechanical ventilation related pneumothorax and treatment were analyzed.Results:Among the 130 patients with COVID-19 in critical condition, 7 (5.38%)cases had mechanical ventilation related pneumothorax (including bilateral and unilateral pneumothorax). All the 7 pneumothorax patients received bedside closed drainage, oxygen saturation and oxygen partial pressure were significantly improved after closed thoracic drainage.No statistical differences were found in other indexes (pH, lactic acid, PCO 2, oxygenation index). Conclusion:For large critical COVID-19 care centers, the involvement of thoracic surgeons are recommended to deal with the thoracic complications associated with mechanical ventilation. After the occurrence of pneumothorax, if there are no other obvious contrainstances, thoracic closed drainage should be given in time.
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Objective To research the application of "Z" chest drainage and modified incision and closure techniques for single-incision VATS.Methods 422 patients by uniportal VATS were divided into three groups:282 in experimental group("Z" Chest drainage with 16 F stomach tube),male 156,female 126,median age is 55 years old;100 in control group 1 (traditional chest drainage with 16 F stomach tube),male 58,female 42,median age is 53 years old;40 in control group 2 (traditional chest drainage with 34 F chest tube),male 24,female 16,median age is 52 years old.To compare the incidence rate of incision exudating、poor healing of incision and debridement between the 3 groups.Results The age,sex and surgical method of the three groups has no statistical significance.Incidence rate of incision exudating of experimental group,control group 1 and control group 2:5 (1.8％,5/282),5 (5.0％,5/100) and 6 (15.0％,6/40);Poor healing of incision of the three groups:0,1 (1.0％,1/100) and 3(7.5％,3/40);debridement of the three groups:0,0 and 3(7.5％,3/40).For the healing of incision,control group 1 was better than control group 2;and experimental group was better than control group 1.Conclusion "Z" chest drainage and modified incision and closure techniques decreased the incidence rate of incision exudate 、poor healing of incision and debridement,it could be useful to obtain a better cosmetic effect after single-incision VATS.
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Objective To investigate the results of non dissecting thoracic duct ligation cutting in treatment of recurrent chylothorax.Methods 22 patients suffered from recurrent chylothorax after original thoracic duct ligation surgery were enrolled and their clinical characteristics were collected,including previous thoracic surgical procedure, previous surgical approach,recurrent chylothorax side and postoperative complications.The probable causes of chylothorax recurrence were analyzed and targeted improvements were made,based on the traditional mass ligation procedure of the thoracic duct.Through the previous approach,non dissecting thoracic duct ligation combined with transection of the posterior mediastinal tissue,except esophagus and thoracic aorta,was applied during the reoperation for the recurrent chylothorax.Results All the patients were recovery form chylothorax after reoperations.There were no severe postoperative complications except one patient suffered from respiratory failure.All the patients discharged evenly without chylothorax recurrence during one-year follow-up period.Conclusion Recurrent chylothorax could be successfully and safely treated by non-anatomical mass ligation combined with transection of the thoracic duct,for the anatomical foundation of chylothorax recurrence had been eliminated.
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Objective To investigate the security and efficacy of one stage and bilateral resection of thymic tissue and clearance of mediastinal fat by uniportal-video-assisted thoracic surgery(VATS) to cure patients with myasthenia gravis(MG).Methods A number of 131 patients with MG who underwent resection of thymic tissue and clearance of mediastinal fat by VATS in one single center from February 2009 to December 2013 were selected in this retrospective study.76 patients underwent unilateral resection of thymic tissue and clearance of mediastinal fat by three portal VATS from February 2009 to March 2012 and 55 patients underwent one stage and bilateral resection of thymic tissue and clearance of mediastinal fat by small uniportal-VATS from April 2012 to December 2013.The time for operation,the bleeding volume during operation,the volume of postoperative drainage and drainage time,the improvement of symptoms,the postoperative pain,hospital stays and the occurrence of myasthenia gravis crisis were compared between the two groups.Results The general condition and pathological type did not have significant statistical differences between the two groups.The operating time in the uniportal-VATS group was significantly longer than that in three portal VATS group,but the pain was lighter,and the hospital stay was shorter.There were no significant differences between groups in terms of blood loss,postoperative drainage time,and volume of drainage.The follow-up was from 32 to 90 months,and 118 (90.08％)patients completed the follow up.94.5 ％ of the patients in uniportalVATS group acquired complete stable remission(CSR),while it was 84.2％ in three portal VATS group(P ＜ 0.05),and the uniportal-VATS group had lower rate of myasthenic crisis (P ＜0.05).Conclusion One stage and bilateral resection of thymic tissue and clearance of mediastinal fat by small uniportal-VATS is safe and effective with shorter hospital stay and less pain,and it can get higher CSR and less myasthenic crisis,its efficacy is superior to traditional three portal VATS.
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Objective To investigate the clinical characteristics,surgical strategy,pathological features and prognosis of pulmonary pleomorphic carcinoma.Methods The clinicopathological data of 23 patients with pulmonary pleomorphic carcinoma who underwent surgical resection from January 201 0 to March 201 4 in Tongji Hospital were collected.Results There were 1 6 male patients and 7 female pa-tients,with the male /female ratio of 2.3∶1 .The mean age of was 54(35 ~75)years old.A total of 1 7 pa-tients were heavy smokers and the mean smoking index was 688(400 -1 200).The initial main symptoms were cough,blood in phlegm and hemoptysis.It was difficult for fiberoptic bronchoscopy to confirm the di-agnosis.All patients underwent surgical resection,including 22 cases of radical resection and one case of biopsy.Microscopically,neoplastic epithelial cells and pleomorphic components were found in pulmonary pleomorphic carcinoma in 1 9 cases,and pleomorphic components only in the other 4 cases.Positive CK ex-pression in pleomorphic components was observed.The longest survival time was 1 8 months and the pa-tient was still alive.The median survival time was 1 2 months.Conclusion Pulmonary pleomorphic carci-noma usually occurs in middle-aged and elderly male smokers.Immunohistochemistry staining contribute to the diagnosis.The main treatment is surgery and the prognosis is poor.
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Objective To discover the risk factors of acute renal insufficiency(ARI) in perioperative of non-small cell lung cancer(NSCLC).Methods We took a retrospective study to analysis and summarize the clinical features of 33 ARI cases and 721 controls,all subjects were histopathologically confirmed NSCLC from January 2007 to October 2013.Logistic regression analysis was conducted to analyze the association between the risk factors and ARI.Results There were significant differences between the two groups in operation age,level of preoperative creatinine,preoperative rehydration and the use of plasma substitutes.After adjustment by confounding factors,operation age older than 60 years old and the use of plasma substitutes had higher risk of ARI [adjusted OR was 2.93 (1.30-6.62),95 ％ CI was 6.04 (1.41-25.87),respectively].Preoperative rehydration was protective factor of ARI(adjusted OR was 0.37,95％ CI was 0.17-0.83).Conclusion Operation age (≥ 60 years old) and the use of blood substitutes are independent risk factors of ARI,while preoperative rehydration can reduce the incidence of ARI after surgery.
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We accidentally found an unusual case of a middle aged Tibetan woman who had eight metallic foreign bodies (eight needles) in her head, chest and abdomen. These needles were not related to any surgical intervention or trauma. The diagnosis "metallic foreign bodies" cannot usually be made in an acute setting. Some patients may present chronic symptoms, such as infection or pain. However, in some cases, the patients do not have any symptoms.
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Adult , Female , Humans , Abdominal Cavity , Foreign Bodies , Diagnostic Imaging , Incidental Findings , Metals , Radiography , Skull , Thoracic CavityABSTRACT
Objective In order to improve the diagnosis accuracy , 18F-FDG PET/CT results of 169 cases of lung lesions were analyzed. Methods The data of 169 pathological diagnosed patients were collected. SPSS 18.0 was used for the data analysis. Results In 169 cases, 122 cases were proved malignant by patholog-ical diagnosis, in which 110 cases were correctly diagnosed by PET/CT. 47 cases were proved benign by patho-logical diagnosis, in which 15 cases were correctly diagnosed by PET/CT. The sensitivity was 90.2%, specificity was 31.9%, and the accuracy was 74.0%. Conclusion In order to improve the accuracy rate of PET/CT exam-ination and reduce the existence of false positive cases and false positive cases , we should estimate SUV (max) objectively and diagnose according to the size of the lesion , clinical history and laboratory results.
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Objective The difficulty of full thoracoscopic Ivor-Lewis is the lack of a safe and low cost anastomosis.By improving the surgical process,to explore the application of circular stapler in the intrathoracic esophagogastric anastomosis.The thoracoscopic operation mode of esophageal cancer changes from simply following the McKoewn procedure to Ivor-Lewis and McKoewn procedure.Methods Retrospective analysis 123 cases of implementation thoracoscopic esophageal cancer from July 2009 to February 2013,which including the cases of intrathoracic anastomosis and cervical anastomosis.Divided it into two groups:intrathoracic anastomosis groups,which including thoracoscopic esophagectomy resection,gastroesophageal anastomosis and anastomotic pedicled omentum embedding,the cervical anastomosis groups,which including thoracoscopic esophageal free and gastroesophageal neck anastomosis.To comparing the incidence of ARDS,postoperative hoarseness,anastomotic complications (Anastomotic leakage and anastomotic strictures within two months after surgery),guardianship time of ICU and postoperative hospital stay between the two groups.Results All the patients were no deaths.The cervical anastomosis group operative time was significantly lower than the intrathoracic anastomosis group.The incidence of anastomotic fistula and anastomotic stricture of intrathoracic anastomosis group was significantly lower than that of the cervical anastomosis group,total hospitalization time of the intrathoracic anastomosis group were significantly lower than that of the cervical anastomosis group,there is no significant differences in postoperative hoarseness and ARDS incidence between the two groups.Conclusion For the lower esophageal carcinoma,it is technically mature and safe to apply the circular stapler for Ivor-Lewis surgery and sleeve omentumembedding anastomotic technique in full thoracoscopic,and the technology should be widely applied; for the upper esophagealcarcinoma,McKoewn procedure should be applied.
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Objective To investigate the expression of miR-200b in lung cancer and its relationship with clinicopathological features of lung cancer.Methods The specimens of lung tumor tissue and adjacent normal lung tissue of 36 cases of lung cancer who received surgical treatment in our department were collected,and then quantitative real time PCR (qRT-PCR) was applied to determine the expression of miR-200b in lung cancer tissue and adjacent normal lung tissue.Results The expression of miR-200b in lung cancer was significantly lower than adjacent normal lung tissue (P =0.000),and in small cell lung cancer was also significantly lower than adenocarcinoma and squamous cell carcinoma (0.13 ± 0.09 vs.0.64 ± 0.33,0.75 ± 0.30) (P =0.005 and P =0.001).The expression of miR-200b in patients with positive lymph nodes,advanced stage of lung cancer and in smokers were significantly lower than those with negative lymph nodes,early stage of lung cancer and in non-smokers,respectively (0.52 ± 0.29 vs.0.87 ± 0.35,0.46 ±0.25 vs.0.90 ±0.32,0.52 ±0.27 vs.0.90 ±0.39) (P =0.004,P =0.000 and P =0.015).Conclusions Low expression of miR-200b may participate in the occurrence and progression of lung cancer,especially in small cell lung cancer,and correlates with the metastasis of lung cancer.The down-regulated expression of miR-200b may be induced by smoking.Thus,miR-200b perhaps is a new target for the treatment of lung cancer.
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In order to confirm the existence of indoleamine 2, 3-dioxygenase (IDO) gene in swine, and to clone the novel gene followed by the molecule structure properties and expression pattern analysis, the porcine mRNA sequences homologous to human IDO were obtained from GenBank database by bioinformatics method. By using RT-PCR, the IDO gene was cloned from porcine endothelial cell line and the accuracy of the nucleic acid sequence was confirmed, and the expression pattern of the gene was detected. The three-dimensional structure model of porcine IDO was built referring to the tertiary structure of human IDO using biological sequence analysis software and database. The results showed that the porcine IDO was identified by sequencing. The nucleotide sequences were confirmed as a novel gene after submitted to Genbank. Porcine IDO was expressed in the lung, thymus, epididymis and anterior chamber with a basic level, however in peripheral blood mononuclear cells (PBMCs) the IDO gene was highly expressed. The three-dimensional structure model of porcine IDO was similar to that of human IDO. It was suggested that identification of the structure information of porcine IDO is essential to further investigate the immunologic function of the gene. Study of IDO on NK cells-mediated xenograft rejection will be a novel therapeutic target for the development of xenotransplantation.
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In order to confirm the existence of indoleamine 2, 3-dioxygenase (IDO) gene in swine, and to clone the novel gene followed by the molecule structure properties and expression pattern analysis, the porcine mRNA sequences homologous to human IDO were obtained from GenBank database by bioinformatics method. By using RT-PCR, the IDO gene was cloned from porcine endothelial cell line and the accuracy of the nucleic acid sequence was confirmed, and the expression pattern of the gene was detected. The three-dimensional structure model of porcine IDO was built referring to the tertiary structure of human IDO using biological sequence analysis software and database. The results showed that the porcine IDO was identified by sequencing. The nucleotide sequences were confirmed as a novel gene after submitted to Genbank. Porcine IDO was expressed in the lung, thymus, epididymis and anterior chamber with a basic level, however in peripheral blood mononuclear cells (PBMCs) the IDO gene was highly expressed. The three-dimensional structure model of porcine IDO was similar to that of human IDO. It was suggested that identification of the structure information of porcine IDO is essential to further investigate the immunologic function of the gene. Study of IDO on NK cells-mediated xenograft rejection will be a novel therapeutic target for the development of xenotransplantation.
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Animals , Amino Acid Sequence , Base Sequence , Cell Line , Cloning, Molecular , Methods , Endothelial Cells , Metabolism , Indoleamine-Pyrrole 2,3,-Dioxygenase , Genetics , Metabolism , Molecular Sequence Data , Sequence Alignment , SwineABSTRACT
ObjectiveTo discuss the method, technical main points and initial efficacy of minimally invasive correction of pectus carinatum. MethodsFive patients underwent minimal invasive operation for pectus carinatum. The pectus carinatum was corrected by a curved Nuss steel bar applying pressure to the anterior chest. The steel bar was placed subcutaneously anterior to the protruding sternum and locked to the ribs through two plates. ResultsFive patients received operations successfully without complications. Operation time was ( 102.6 ± 23.8) min, blood loss was( 14.0 ± 9.7) ml,postoperative hospital stay was(6.6 ± 1.6) d. Postoperative follow-up was 4-12 months, no steel bar movement was found.ConclusionThe minimally invasivecorrection of pectus carinatum seems to be a simple,safe and effective technique with minimal complications.