Analysis of risk factors for intercostal muscular avulsion after Nuss procedure for pectus excavatum / 中华胸心血管外科杂志

ABSTRACT

Objective:To explore the incidence and risk factors of intercostal muscular avulsion for pectus excavatum after Nuss procedure.Methods:From April 2012 to April 2019, the clinical data were analyzed retrospectively for 159 hospitalized cases of Nuss procedure for pectus excavatum in Xi'an Children' s Hospital. The age ranged from 3.2 to 17.0 years old, mean(6.8±3.4) years old; 124 males, 35 females. Haller index ranged from 2.7 to 7.5(mean 4.0±1.0); intercostal muscular avulsion was 13 cases, 9 males, 4 females.The age ranged from 3.4 to 18.4 years old, mean(4.8±1.5) years old. Follow-ups were conducted for at least 20 months.Analyzed retrospectively the relevant data included age, gender, haller index, t test and χ2 test was used for statistical analysis.Results:There were statistically significant differences between intercostal muscle avulsion and age after funnel chest operation ( P=0.001), and between intercostal muscle avulsion and typing( P=0.034). Children at young ages and asymmetric pectus excavatum were prone to intercostal muscle avulsion. There were no significant differences in gender, Haller index, surgical method and intercostal muscle avulsion( P>0.05). Conclusion:The cause of intercostal muscle avulsion after postoperative complication of pectus infundibulis Nuss is mostly related to age. Children at young ages, especially asymmetric pectus excavatum are prone to intercostal muscle avulsion. We recommend surgery after the age of 6 for avoid intercostal muscle avulsion after funnel chest operation.