Ran Xudong,Shen Weijia,Li Xin,et al.Mini-invasive inverted Nuss procedure for correcting pectus carinatum[J].Journal of Clinical Pediatric Surgery,,22():529-532.[doi:10.3760/cma.j.cn101785-202210052-006]
Mini-invasive inverted Nuss procedure for correcting pectus carinatum
- Keywords:
- Pectus Carinatum; Orthopedic Procedures; Minimally Invasive Surgical Procedures; Treatment Outcome; Postoperative Complications; Adolescent
- Abstract:
- Objective To explore the surgical approaches, outcomes and complications of mini-invasive inverted Nuss procedure for correcting pectus carinatum (PC) in children.Methods From July 2020 to December 2021, retrospective anlysis was performed for clinical data of mini-invasive inverted Nuss procedure for correcting PC.There were 14 boys and 1 girl with a median age of 19.6(141-180) month and a median weight of 44(36-55) kg.Hailer index had a median value of 1.94(1.76-2.24).Steel bar was pressed anteriorly onto sternum via a lateral thoracic incision and fixed with steel wires.Inverted Nuss procedure was performed alone (n=9) and with Nuss procedure (n=6).Results All procedures were successfully completed without intraoperative complications.The median operative duration was 100(70-225) min and the length of postopretive stay (5-7) day.The bar was implanted for 1.5 years.Follow-ups were conducted at Month 1/3/6/12.One case recurred due to sternal callapse at Month 1 post-operation.Another child was reoperated for break of steel wire during vigorous exercise at Month 3 post-operation.Conclusion Inverted Nuss procedure may correct PC with minimal injury and a quick recovery.Its middle/long-term outcomes should be evaluated by a larger sample size and longer follow-ups.
References:
[1] 刘青, 吴晔明.鸡胸的治疗进展[J].临床小儿外科杂志, 2013, 12(1):64-66, 75.DOI:10.3969/j.issn.1671-6353.2013.01.020. Liu Q, Wu YM.Therapeutic advances of pectus carinatum[J].J Clin Ped Sur, 2013, 12(1):64-66, 75.DOI:10.3969/j.issn.1671-6353.2013.01.020.
[2] Abramson H.A minimally invasive technique to repair pectus carinatum.Preliminary report[J].Arch Bronconeumol, 2005, 41(6):349-351.DOI:10.1016/S1579-2129(06)60235-8.
[3] Suh JW, Joo S, Lee GD, et al.Minimally invasive repair of pectus carinatum in patients unsuited to bracing therapy[J].Korean J Thorac Cardiovasc Surg, 2016, 49(2):92-98.DOI:10.5090/kjtcs.2016.49.2.92.
[4] Croitoru DP, Kelly REJr, Goretsky MJ, et al.Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients[J].J Pediatr Surg, 2002, 37(3):437-445.DOI:10.1053/jpsu.2002.30851.
[5] Abramson H, D’Agostino J, Wuscovi S.A 5-year experience with a minimally invasive technique for pectus carinatum repair[J].J Pediatr Surg, 2009, 44(1):118-124.DOI:10.1016/j.jpedsurg.2008.10.020.
[6] 段贤伦, 章鹏, 商子寅, 等.鸡胸微创外科治疗59例报告[J].中国微创外科杂志, 2017, 17(9):818-821, 826.DOI 10.3969/j.issn.1009-6604.2017.09.016. Duan XL, Zhang P, Shang ZY, et al.Mini-invasive surgery for pectus carinatum:a report of 59 cases[J].Chin J Minim Invasive Surg, 2017, 17(9):818-821, 826.DOI:10.3969/j.issn.1009-6604.2017.09.016.
[7] Yuksel M, Lacin T, Ermerak NO, et al.Minimally invasive repair of pectus carinatum[J].Ann Thorac Surg, 2018, 105(3):915-923.DOI:10.1016/j.athoracsur.2017.10.003.
[8] ?zkaya M, Bilgin M.Minimally invasive repair of pectus carinatum:a retrospective analysis based on a single surgeon’s 10 years of experience[J].Gen Thorac Cardiovasc Surg, 2018, 66(11):653-657.DOI:10.1007/s11748-018-0975-1.
[9] 曾骐, 郭卫红, 张娜, 等.鸡胸的微创外科治疗[J].中华胸心血管外科杂志, 2010, 26(2):113-115.DOI:10.3760/cma.j.issn.1001-4497.2010.02.014. Zeng Q, Guo WH, Zhang N, et al.Mini-invasive surgery for correcting pectus carinatum[J].Chin J Thorac Cardiovasc Surg, 2010, 26(2):113-115.DOI:10.3760/cma.j.issn.1001-4497.2010.02.014.
[10] 胡峰, 蒋连勇, 毕锐, 等.一种新型钢板在鸡胸微创手术中的应用[J].中华胸心血管外科杂志, 2019, 35(5):257-259.DOI:10.3760/cma.j.issn.1001-4497.2019.05.001. Hu F, Jiang LY, Bi R, et al.Applying a new steel bar for pectus carinatum during mini-invasive surgery[J].Chin J Thorac Cardiovasc Surg, 2019, 35(5):257-259.DOI:10.3760/cma.j.issn.1001-4497.2019.05.001.
[11] Geraedts TCM, Daemen JHT, Vissers YLJ, et al.Minimally invasive repair of pectus carinatum by the Abramson method:a systematic review[J].J Pediatr Surg, 2022, 57(10):325-332.DOI:10.1016/j.jpedsurg.2021.11.028.
Memo
收稿日期:2022-10-25。
基金项目:苏州市儿童结构畸形重点实验室（SZS2022018）
通讯作者:冉旭东,Email:rxdsz_2004@126.com