Wu Na,Xie Yimin,Chen Siyuan,et al.Research advances of mini-invasive Nuss operation in the treatment of pectum excavatum in children[J].Journal of Clinical Pediatric Surgery,2020,19(02):176-180.[doi:10.3969/j.issn.1671-6353.2020.02.017]
微创Nuss手术治疗儿童漏斗胸的研究进展
- Title:
- Research advances of mini-invasive Nuss operation in the treatment of pectum excavatum in children
- 分类号:
- R726.1;R655;R561
- 摘要:
- 漏斗胸是一种胸壁凹陷性畸形，Nuss手术是治疗漏斗胸的一种微创手术，具有创伤小、操作简便、并发症少、手术效果良好等优点，已成为治疗漏斗胸的首选术式。随着Nuss手术的不断改良以及腔镜技术的提高，Nuss手术的适用范围不断扩大，胸腔镜辅助Nuss手术在临床应用广泛。作者在Pubmed、万方数据、中国知网等数据库，以漏斗胸、Nuss手术、手术治疗为关键词，查阅相关文献，将微创Nuss手术治疗漏斗胸的概况、技术要点、争议及改良方法等作一综述。虽然Nuss手术的发展给漏斗胸患儿带来福音，但其临床应用的具体问题和中远期疗效仍需进一步研究。
- Abstract:
- Pectum excavatum (PE) is one kind of chest wall pitting deformity.As a primary mini-invasive operation for PE,Nuss procedure offers multiple advantages,such as minimal trauma,simple handling,fewer complications and better outcomes.With constant developments of Nuss operation and technological improvements of thoracoscope,applicable scope of Nuss procedure has expanded further.Thoracoscope-assisted Nuss technique is widely employed in clinical practices.The keywords of "pectum excavatum","Nuss procedure" and "surgical treatment" were searched within the databases of PubMed,Wanfang and CNKI.After consulting the relevant literatures,overviews,operating procedures,technical controversies and modified methods were summarized.The development of Nuss operation has brought great benefits to PE patients.However,its practical problems and medium/long-term efficacies require further studies.
参考文献/References:
1 Huddleston CB.Pectus excavatum[J].Semin Thorac Cardiovasc Surg,2004,16(3):225-232.DOI:10.1053/j.semtcvs.2004.08.003.
2 Daniel PC,Robert EK,Mieheal J,et al.Experience and modification up-date for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients[J].J Pediatr Surg,2002,37:437-445.DOI:10.1053/jpsu.2002.30851.
3 Fonkalsrud EW.Open repair of pectus excavatum with minimal cartilage resection[J].Ann Surg,2004,240(3):231-235.DOI:10.1097/01.sla.0000133116.16484.bb.
4 Park HJ,Lee SY,Lee CS,et al.The Nuss procedure for pectus excavatum:evolution of techniques and early results on 322 patients[J].Ann Thorac Surg,2004,77(1):289-295.DOI:10.1016/S0003-4975(03)01330-4.
5 Nuss D,Kelly RE Jr,Crotitoru,et al.A 10-year review of a minimally invasie technique for the correction of pectus excavatum[J].J Pediatr Surg,1998.33:545-552.
6 曾骐,彭芸,贺延儒,等.Nuss手术治疗小儿漏斗胸(附60例报告)[J].中华胸心血管外科杂志,2004,20(4):223-224.DOI:10.3760/cma.jissn.1001-4497.2004.04.012. Zeng Q,Peng Y,He YR,et al.Nuss procedure for the correction of pectus excavatum-review of 60 cases[J].Chin J Thoracic & Cardiovasc Surg,2004,20(4):223-224.DOI:10.3760/cma.j.issn.1001-4497.2004.04.012.
7 Pilegaard HK,Licht PB.Early results following the Nuss operation for pectus excavatum a single in stitution experience of 383 patients[J].Interact Cardiovasc Thorac Surg,2008,7(1):54-57.DOI:10.1510/icvts.2007.160937.
8 Kim HK,Choi YH,Cho YH,et al.A comparative study of pericostal and submuscular bar fixation technique in the Nuss procedure[J].Korean Med Sci,2007,22(3):254-257.DOI:10.3346/jkms.2007.22.2.254.
9 刘文英.关于漏斗胸手术治疗的若干问题[J].临床小儿外科杂志,2016,15(2):110-113.DOI:10.3969/j.issn.1671-6353.2016.02.003. Liu WY.Several issues regarding surgical treatment of pectus excavatum[J].J Clin Ped Sur,2016,15(2):110-113.DOI:10.3969/j.issn.167-6353.2016.02.003.
10 Donald N,Kelly RE.Indications and technique of Nuss procedure for pectus excavatum[J].Thorac Surg Clin,2010,20(4):583-597.DOI:10.1016/j.thorsurg.2010.07.002.
11 Udholm S,Maagaard M,Pilegaard H,et al.Cardiac function in adults following minimally invavise repair of pectus excavatum[J].Interact Cardiovasc Thorac Surg,2016,22(5):525-529.DOI:10.1093/icvts/ivw007.
12 Hyung JP,Sook WS,Jae KP,et al.How early can we repair pectus excavatum:the early the better[J].Eur J Cardio Thoracic Surg,2012,42(4):667-672.DOI:10.1093/ejcts/ezs130.
13 Koichi O,Tetsuro N,Takashi A,et al.Modification of the Nuss procedure for pectus excavatum to prevent cardiac perforation[J].J Pediatr Surg,2009,44(12):2426-2430.DOI:10.1016/j.jpedsurg.2009.09.006.
14 Liu JF,Zhu SH,Xu B.Early results of 18 adults,following a modified Nuss operation for recurrent petus excavatum[J].Eur J Cardiothorac Surg,2013,43(2):279-282.DOI:10.1093/ejcts/ezs282.
15 汤绍涛,王勇,毛永忠,等.胸腔镜下手术治疗小儿漏斗胸38例报告[J].中国微创外科杂志,2006,6(9):683-685.DOI:10.3969/j.issn.1009-6604.2006.09.018. Tang ST,Wang Y,Mao YZ,et al.Thoracoscopic Nuss procedure for the correction of pectus excavatum in 38 children[J].Chin J Min Inv Surg,2006,6(9):683-685.DOI:10.3969/j.issn.1009-6604.2006.09.018.
16 Coln E,Carrasco J,Coln D.Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum[J].J Pediatr Surg,2006,41(4):683-686.DOI:10.1016/j.jpedsurg.2005.12.009.
17 Potaezek T,Duda S.Comparison of postoperative period in patients with pectus excavatum treated with Nuss technique and ravitch technique[J].Ortop Traumato Rehabil,2015,17(6):577-686.DOI:10.5604/15093492.1193010.
18 Klaus S,Andreas KS,Gregori D,et al.Submuscular bar,multiple pericostal bar fixation,bilateral thoracoscopy:a modified Nuss repair in adolescents[J].J Pediatr Surg,2002,37(9):1276-1280.DOI:10.1053/jpsu.2002.34982.
19 Kelly RE,Gorestsky MJ,Obermeyer R,et al.Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1215 patients[J].Ann Surg,2010,252(6):1218-1222.DOI:10.1097/SLA.0b013e3181effdce.
20 Pilegaard HK.Nuss technique in pectus excavatum:a mono-institutional experience[J].J Thorac Dis,2015,7(Suppl 2):S172-S176.DOI:10.3978/j.issn.2072-1439.2015.04.07.
21 Casamassima MG,Goldstein SD,Salazar JH,et al.Perioperative strategies and technical modifications to the Nuss repair for pectus excavatum in podiatric patients:a large volume,single institution experience[J].J Pediatr Surg,2014,49(4):575-582.DOI:10.1016/j.jpedsurg.2013.11.058.
22 Sigalet DL,Montgomery DL,Harden J.Cardiopulmonary effects of closed repair of pectus excavatum[J].J Pediatr Surg,2003,38(3):380-385.DOI:10.1053/jpsu.2003.50112.
23 Aronson DC,Bosgraaf RP,Merz EM,et al.Lung function after the minimal invasive pectus excavatum repair (Nuss procedure)[J].World J Surg,2007,31(7):1518-1522.DOI:10.1007/s00268-007-9081-8.
24 Chen Z,Amos EB,Luo H,et al.Comparative pulmonary functional recovery after Nuss and Ravitch procedures for pectus excavatum repair:a meta-analysis[J].J Cardiothorac Surg,2012,7:101.DOI:10.1186/ 1749-8090-7-101.
25 Balci AE,Eren S,Ozyurtkan MO.Symmetrical excessive pectus excavatum in children[J].Asian Cardiovasc Thorac Ann,2013,21(6):683-688.DOI:10.1177/0218492312467538.
26 Fallon SC,Slater BJ,Nuchtern JG,et al.Complications related to the Nuss procedure:minimizing tisk with operative technique[J].J Pediatr Surg,2013,48(5):1044-1048.DOI:10.1016/j.jpedsurg.2013.02.025.
27 Ravenni G,Actis Dato GM,Zingarelli E,et al.Nuss procedure in adult pectus excavatum:a simple artifice to reduce sternal tension[J].Interact Cardiovasc Thorac Surg,2013,17(1):23-25.DOI:10.1093/icvts/ivtl36.
28 Del Frari B,Schwabegger AH.Clinical results and patient satisfaction after pectus excavatum repair using the MIRPE and MOVARPE technique in adults:10-year experience[J].Plast Reconstr Surg,2013,132(6):1591-1602.DOI:10.10.1097/PRS.0b013e3182a97dc1.
29 吴茂军,宋波,侯龙龙,等.改良Nuss手术矫治先心病手术后继发性漏斗胸的初步经验[J].临床小儿外科杂志,2017,16(3):259-261.DOI:10.3969/j.issn.1671-6353.2017.03.014. Wu MJ,Song B,Hong LL,et al.Preliminary experiences of modified Nuss procedure for acquired pectus excavatum after congenital heart disease surgery[J].J Clin Ped Sur,2017,16(3):259-261.DOI:10.3969/j.issn.1671-6353.2017.03.014.
30 钟斌,刘辉,吴金华,等.单切口胸腔镜辅助Nuss手术治疗26例儿童漏斗胸的疗效分析[J].临床小儿外科杂志,2017,6(5):506-509.DOI:10.3969/j.issn.1671-6353.2017.05.021. Zhong B,Liu H,Wu JH,et al.Modified single-incision thoracoscopic Nuss procedure for pectus excavatum:a report of 26 cases[J].J Clin Ped Sur,2017,16(5):506-509.DOI:10.3969/j.issn.1671-6353.2017.05.021.
31 宁金波,谢义民,陈强.比较不同手术方式治疗小儿漏斗胸的临床疗效[J].临床小儿外科杂志,2017,16(3):262-265.DOI:10.3969/j.issn.1671-6353.2017.03.15. Ning JB,Xie YM,Chen Q.Efficacies of single-incision Nuss procedures for pectus excavatum[J].J Clin Ped Sur,2017,16(3):262-265,DOI:10.3969/j.issn.1671-6353.2017.03.15.
32 阳广贤,易立文,王敬华,等.双钢板Nuss手术矫治大龄儿童极重度漏斗胸[J].临床小儿外科杂志,2017,16(3):242-243.DOI:10.3969/j.issn.1671-6353.2017.03.010. Yang GX,Yi LW,Wang JH,et al.Nuss procedure for correcting extremely severe pectus excavatum by double braces in elder children[J].J Clin Ped Sur,2017,16(3):242-243.DOI:10.3969/j.issn.1671-6353.2017.03.010.
33 王会,汪风华,梁建华,等.重度漏斗胸伴先天性肺囊性病变同期手术治疗5例[J].临床小儿外科杂志,2016,15(2):129-131.DOI:10.3969/j.issn.1671-6353.2016.02.008. Wang H,Wang FH,Liang JH,et al.One-stage operation for pectus excavatum concomitant congenital cystic lung lesion[J].J Clini Ped Sur,2016,15(2):129-131.DOI:10.3969/j.issn.1671-6353.2016.02.008.
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备注/Memo
收稿日期:2018-07-03。
基金项目:重庆市万州区科技计划项目（编号：wzstc-2018004）
通讯作者:谢乂民,Email:402610872@qq.com