A novel modified Nuss procedure without plate turnover for treatment of adult recurrent pectus excavatum
10.7507/1007-4848.202009072
- VernacularTitle:免翻转钢板矫治成人复发性漏斗胸的临床研究
- Author:
Xiao XIE
1
;
Ju MEI
1
;
Guoqing LI
1
;
Haibo XIAO
1
;
Rui BI
1
;
Lianyong JIANG
1
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200092, P.R.China
- Publication Type:Journal Article
- Keywords:
Recurrent pectus excavatum;
non-turnover plate;
adults;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(10):1212-1215
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of treating adult recurrent pectus excavatum without plate turnover. Methods Twenty-seven patients with recurrent pectus excavatum treated by thoracoscopy-assisted placement without plate turnover from 2010 to 2019 in our hospital were enrolled. There were 23 males and 4 females with the age of 3-29 (12.81±7.79) years at the first operation, and 18-29 (21.74±3.56) years at this operation. Incision of 2-3 cm at bilateral axillary midline of the deepest point of pectus excavatum was made, and an auxiliary incision under xiphoid process was adopted according to the intraoperative situation. Results All patients underwent thoracoscopy-assisted correction of pectus excavatum without bar turnover, and subxiphoid incision was performed in 11 patients. Twenty-five patients had one bar placed, and two patients required two bars. The operation time was 28-45 (33.00±6.44) min. Postoperative Haller index (2.95±0.40) was improved compared with preoperation (4.63±1.03). The postoperative hospital stay was 4-6 (4.00±0.32) day. All patients were followed up for 1-8 years. Complications included poor wound healing in 1 patient, and steel wire fracture and displacement in 1 patient. There was no plate rotation or bar displacement. Fourteen patients removed the bar 29-84 (40.36±13.93) months after the placement. Haller index was improved to 2.43-3.61 (2.86±0.35) during removal of steel plate. Untill June 2020, there was no recurrence of pectus excavatum. Conclusion The treatment of adult recurrent pectus excavatum without plate turnover is satisfactory, and the protection of intercostal muscle and firm fixation is the key to ensure the success of operation and long-term effects.
