Minimally invasive surgery of modified Nuss technique without being turned over for the treatment of adult recurrent pectus excavatum

doi:10.3877/cma.j.issn.2095-8773.2023.03.01

Abstract

Abstract:

Objective

To access the efficacy and safety of minimally invasive surgery of modified Nuss technique without being turned over for the treatment of adult recurrent pectus excavatum.

Methods

From July 2008 to September 2021, 48 adult recurrent pectus excavatum cases were treated with minimally invasive surgery of modified Nuss technique without being turned over in the Department of Thoracic Surgery of Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and in the Department of Cardiothoracic Surgery of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, among which 22 cases were performed previously by Ravitch procedure, 23 cases were Nuss procedure, 2 cases were Ravitch combined with Nuss procedure, 1 case was uncertain respectively.

Results

All 48 cases were performed by minimally invasive surgery of modified Nuss technique without being turned over successfully. The average postoperative hospital stays were 5.58 days. The Hallex index was improved. The complications were mild. The patients were all satisfied with their chest appearance after the operation.

Conclusions

Minimally invasive surgery of modified Nuss technique without being turned over is effective and safe, which will be a surgical choice for the treatment of adult recurrent pectus excavatum in the future.

Key words: Recurrent pectus excavatum, Ravitch procedure, Nuss procedure

Hao Li, Zhijun Zhu, Lei Wang, Fengqing Hu, Guoqing Li, Mingsong Wang. Minimally invasive surgery of modified Nuss technique without being turned over for the treatment of adult recurrent pectus excavatum[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2023, 10(03): 131-136.

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https://zhxbwkdzzz.cma-cmc.com.cn/EN/Y2023/V10/I03/131

Figures/Tables 4

References 26

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资料	病例（N＝48）
年龄（岁）	22.89±4.53
性别[例（%）]
男	41（85.42）
女	7（14.58）
术前症状[例（%）]
无症状	16（33.33）
呼吸不适	26（54.17）
胸痛	9（18.75）
其他	2（4.17）
前次术式[例（%）]
Ravitch	22（45.83）
Nuss	23（47.92）
Ravitch和Nuss	2（4.17）
不详	1（2.08）
前次距复发时间（年）	7.73±6.54
术前平均Haller指数	4.82±1.54
术后平均Haller指数	3.09±0.75
矫形器数量[例（%）]
1	45（93.75）
2	3（6.25）
剑突辅助数[例（%）]	12（25.00）
胸肋骨部分切开或切除数[例（%）]	2（4.17）
术后平均住院时间（天）	5.58±2.52
并发症[例（%）]
胸腔积液	20（41.67）
气胸	15（31.25）
肺炎	5（10.42）
肺不张	8（16.67）
伤口愈合不佳	3（6.25）
矫形器移位	4（8.33）
死亡	0

资料	病例（N＝48）
年龄（岁）	22.89±4.53
性别[例（%）]
男	41（85.42）
女	7（14.58）
术前症状[例（%）]
无症状	16（33.33）
呼吸不适	26（54.17）
胸痛	9（18.75）
其他	2（4.17）
前次术式[例（%）]
Ravitch	22（45.83）
Nuss	23（47.92）
Ravitch和Nuss	2（4.17）
不详	1（2.08）
前次距复发时间（年）	7.73±6.54
术前平均Haller指数	4.82±1.54
术后平均Haller指数	3.09±0.75
矫形器数量[例（%）]
1	45（93.75）
2	3（6.25）
剑突辅助数[例（%）]	12（25.00）
胸肋骨部分切开或切除数[例（%）]	2（4.17）
术后平均住院时间（天）	5.58±2.52
并发症[例（%）]
胸腔积液	20（41.67）
气胸	15（31.25）
肺炎	5（10.42）
肺不张	8（16.67）
伤口愈合不佳	3（6.25）
矫形器移位	4（8.33）
死亡	0

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