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@#Objective To explore the clinical efficacy of thoracoscopy-assisted modified Nuss procedure for pectus excavatum (PE) in children. Methods The clinical data of patients with PE who underwent thoracoscopy-assisted modified Nuss procedure from October 2013 to October 2020 in Daping Hospital were retrospectively analyzed. Results A total of 86 patients were collected, including 79 males and 7 females with a mean age of 14.03±3.36 years. The operations were performed successfully in all patients without intraoperative cardiac vascular injury or perioperative death. The mean operation time was 87.30±33.45 min, bleeding volume was 19.94±14.60 mL, and the postoperative hospitalization stay time was 6.89±2.59 d. Early postoperative complications included 2 patients of pneumothorax, 2 patients of wound fat liquefaction and infection, 2 patients of bar flipping and displacement. One patient had bar displacement 1 year after the surgery. The total complication rate was 8.14%. All patients were followed up for 3-42 months. The bars were taken out about 36 months after the surgery. According to the evaluation criteria of orthopedic effect, 68 (79.07%) patients were excellent, 10 (11.63%) patients were good, 5 (5.81%) patients were moderate and 3 (3.49%) patients were poor. Conclusion Minimally invasive and individualized shaping via the Nuss procedure for PE children is safe and convenient, with satisfied effect. It is worthy of popularization in the clinic.
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@#The surgical treatment of pectus excavatum has a history of more than 100 years, which has gone through from traditional open surgery to the current popular minimally invasive surgery. Nuss procedure, as the most classic minimally invasive operation, has been improved in accordance with the clinical needs since its inception to achieve fewer complications and better results, but there are still limitations that are difficult to break through, attracting a large number of scholars to make continuous innovation and develop updated devices and operation methods. This article reviews the history of funnel chest surgery, application and improvement of Nuss operation, double compression and complete fixation bar system and Wang procedure.
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Objective To summarize the preliminary experience of surgical treatment of recurrent pectus excavatum. Methods A total of 23 cases of recurrent pectus excavatum treated in our hospital from January 2012 to December 2014 were reviewed retrospectively. Of the 23 cases, the Nuss method was employed in 15 cases, the modified Nuss method in 6 cases, the Nuss operation and osteotomy in 1 case, and the Ravitch operation in 1 case. Results The surgery was successfully completed in all the 23 patients, without serious complications. The intraoperative blood loss was 10-150 ml (median, 20 ml). The postoperative hospital stay was 4-15 days (mean, 7. 1 days). After operation, 2 cases had more drainage, which were given active thoracic drainage and nutrition. The 23 patients were given removal of steel plate at 2 years after operation, and no recurrence was seen. Conclusions The Nuss operation can be used as the first choice for patients with pectus excavatum repair failure. For patients with recurrence of severe deformity of pectus excavatum, the first choice should be the Ravitch operation.
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BACKGROUND: We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. METHODS: Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. RESULTS: The mean age of the patients was 24.35±13.20 years (range, 14-57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60-2.31), and 2.22±0.19 (range, 1.87-2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5-15 days). Only one patient experienced postoperative complications. CONCLUSION: Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients.
Subject(s)
Adult , Humans , Male , Braces , Length of Stay , Postoperative Complications , Minimally Invasive Surgical Procedures , Thoracic WallABSTRACT
Objective To introduce the surgical cooperation in finger-guided modified Nuss operation. Methods Forty-six patients with pectus excavatum (PE) underwent the finger-guided modified Nuss operation during September 2013 to August 2015. We retrospectively reviewed the surgical data and sumed up the key points for nursing cooperation. Results All the operations were successful. One patient developed preumothorax and chest subcutaneous emphysema;one patient developed pleural effusion. There was no bar shifting in the follow-ups. Conclusions Enough preoperative preparation and good doctor nurse cooperation are critical for the success of operations.