基金项目:江西省赣州市卫计委2015年计划课题(编号:20150109)
目的 探讨单切口胸腔镜辅助Nuss手术治疗儿童漏斗胸的临床疗效。 方法 回顾性分析2012年7月至2016 年7月我们收治的26例漏斗胸患儿临床资料,均行单切口胸腔镜辅助 Nuss 术,其中男性22例,女性4例。年龄最小3岁,最大12岁,平均年龄5.5岁。Haller 指数>3.25。 结果 26例均顺利完成手术,手术时间(65.3±14.2)min,术中出血量(2.5±1.3)mL,住院时间(5.8±1.2)d。术中无心脏穿孔和大血管损伤。术后2例出现右侧少量气胸,无胸腔积液及伤口感染。26例随访6～36 个月,按Croitoru漏斗胸评价标准分均为优,其中16例术后2年取出钢板,无钢板移位及复发。 结论 单切口胸腔镜辅助 Nuss 手术治疗儿童漏斗胸安全有效,手术时间短,创伤小,并发症少,美容效果佳,值得临床推广。
Objective Objective To explore the clinical efficacy of modified single-incision thoracoscopic Nuss procedure for pediatric pectus excavatum. Methods A retrospective review was performed for the clinical data of 26 cases of pectus excavatum from July 2012 to July 2016. There were 22 boys and 4 girls with an average age of 5.5(3-12)years. All of them underwent modified single-incision thoracoscopic Nuss procedure. Haller index was >3.25. Results All procedures were successfully completed. Operative duration was(65.3±14.2)min, intraoperative blood loss(2.5±1.3)ml and hospitalization stay(5.8±1.2)days. There was no instance of intraoperative cardiac perforation or macrovascular injury. There were 2 cases of right minimal pneumothorax. No pleural effusion or infection was reported. The follow-up period was 6 to 36 months. According to the Croitoru's evaluation standard, the scores were excellent. In 16 children, steel plates were removed after 2 years. There was no onset of plate displacement or recurrence. Conclusion Modified single-incision thoracoscopic Nuss procedure with is both safe and effective for pediatric pectus excavatum. With the advantages of shorter operative duration, mini-invasiveness, fewer complications and excellent cosmetics, it is worthy of wider popularization.
