Objective:To summarize the curative effect, safety and experience of non-thoracoscopic modiifed Nuss procedure for correction of pectus excavatum (PE).
Methods:From January 2007 to December 2011, 267 cases of PE patients were selected in our hospital. Among them 85 were treated by thoracoscopic minimally invasive modified Nuss Procedure and 182 by non-thoracoscopic procedure. The operation time, blood loss during operation, length of postoperative hospital stay and effect of treatment were compared retrospectively.
Results:All the 267 patients finished the repair procedure smoothly. The non-thoracoscopic group had advantage in terms of operative time (22.5 min vs 35.1 min, P<0.05). As for the blood loss during operation, length of postoperative hospital stay and effect of treatment, there was no signiifcant difference among the 2 groups (P>0.05). hTere were no deaths.
Conclusion:Non-thoracoscopic minimally invasive modified Nuss procedure is as safe and effective as thoracoscopic Nuss procedure. With advantages of simpliifed operation procedure and shorter operation time, it is easier in practice.

Objective:To compare the properties between decellularized rabbit carotid artery with different cross-linked technologies.Methods:The decellularized rabbit carotid arteries were randomly divided into a photo-oxidation group and a procyanidins group.One group was cross-linked with photo-oxidation and the other group was cross-linked with procyanidins.The in vitro or in vivo properties of the two groups were evaluated by testing heat-shrinking temperature,max tensile strength and the max elongation or by testing tissue structure,inflammatory reaction and calcification degree.Results:The heat-shrinking temperature,max tensile strength and the max elongation were similar in the two groups (P＞0.05).The tissue structure and inflammatory reaction were also similar in the two groups.Mthough the result of Von-Kossa calcium salt stain was slightly different,the calcium content was lower in the procyanidins group than that in the photo-oxidation group (P＜0.05).Conclusion:The grafts by two cross-linked technologies show excellent mechanical capability,lower immunogenicity,good biological stability and anti-calcification ability.The procyanidins group shows a better anti-calcification property than the photo-oxidation group.

OBJECTIVE: To evaluate the safety and efficacy of modified technique for removing Nuss bar after Nuss procedure. METHODS: We reviewed 186 patients undergoing bar removal after repair of pectus excavatum with Nuss procedure at our institution from December 2008 to February 2012. All patients had unilateral incision (metallic stabilizers have been used on one side in all patients). Under general anesthesia with single lumen tracheal tube or laryngeal mask, with the patient lying down in supine position, the bar was pulled out along the thoracic wall without overturning or straightening. RESULTS: Totally 132 patients (71.0%) had the bar removed 2 years after the Nuss procedure, 1 (0.5%) removed within 1 year and 53 (28.5%) removed over 2 and half years. The operation time for bar removal was 9-20 (13.1 ± 3.4) min, and the operative blood loss was 3-20 (5.2 ± 2.7) mL. There was no hemorrhage. Three patients (1.6%) developed mild pneumothorax and none showed infection of incision after the operation. All patients were discharged 1 day after the surgery and followed up for 4-48 (21.4 ± 6.8) months. Recurrence was found in the one who which had the bar removed within 1 year (0.5%). CONCLUSION With modified procedures, Nuss bar can be easily and safely removed 2 years or longer after the Nuss operation. After removing the metallic stabilizer, the bar should be turned and then pulled out along the original surgical incision without bending or turning.
Adolescent ; Blood Loss, Surgical ; Child ; Child, Preschool ; China ; epidemiology ; Device Removal ; methods ; Female ; Funnel Chest ; surgery ; Humans ; Male ; Orthopedic Fixation Devices ; Pneumothorax ; epidemiology ; etiology ; Postoperative Complications ; epidemiology ; prevention & control ; Prostheses and Implants ; Sternum ; surgery ; Young Adult