Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2013
[Nuss procedure by thoracoscopy for minimally invasive correction of pectus excavatum].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Li Bin, Zhang Jianhua, Guo Yunjiu, Wang Zhiqiang, Wang Cheng, Song Tieniu, Yang Jianbao
Аннотация
OBJECTIVE: To summarize the effectiveness of Nuss procedure by thoracoscopy for correction of pectus excavatum.
METHODS: Between September 2009 and January 2012, 33 patients suffering from pectus excavatum underwent Nuss procedure by thoracoscopy. There were 26 males and 7 females, aged from 3 to 22 years (median, 9 years). There was primary operation in 32 cases and reoperation in 1 case after Ravitch procedure. Twenty-four patients had obvious clinical symptoms. The Haller index ranged from 3.3 to 50.1 (mean, 5.6). According to simplified Park classification, 25 cases were classified as symmetric type, 5 as eccentric type, and 3 as unbalanced type.
RESULTS: Intercostal muscle tear occurred in 1 case during operation; pleural effusion, pulmonary infection, and thoracic vertebral pain occurred in 1 case, respectively after operation. The operation time ranged from 38 to 89 minutes (mean, 60.9 minutes). The intraoperative blood loss was 8-90 mL (mean, 26.2 mL). The postoperative hospitalization days were 6-12 days (mean, 7.6 days). All patients were followed up 12-39 months (mean, 25.6 months). Electrocardiogram and chest X-ray film showed that cardiac compression was improved, and symptoms alleviated. At the last follow-up, according to the Nuss standard, the results were excellent in 27 cases, good in 3 cases, and fair in 3 cases, with an excellent and good rate of 90.9%. There was no significant difference in results of effectiveness evaluation among less than 6 years, 6-12 years, and more than 12 years groups (Z= -1.751, P=0.109).
CONCLUSION: Nuss procedure by thoracoscopy has the advantages of little trauma, simple operation, and fast recovery, so it can obtain satisfactory correction of pectus excavatum.
METHODS: Between September 2009 and January 2012, 33 patients suffering from pectus excavatum underwent Nuss procedure by thoracoscopy. There were 26 males and 7 females, aged from 3 to 22 years (median, 9 years). There was primary operation in 32 cases and reoperation in 1 case after Ravitch procedure. Twenty-four patients had obvious clinical symptoms. The Haller index ranged from 3.3 to 50.1 (mean, 5.6). According to simplified Park classification, 25 cases were classified as symmetric type, 5 as eccentric type, and 3 as unbalanced type.
RESULTS: Intercostal muscle tear occurred in 1 case during operation; pleural effusion, pulmonary infection, and thoracic vertebral pain occurred in 1 case, respectively after operation. The operation time ranged from 38 to 89 minutes (mean, 60.9 minutes). The intraoperative blood loss was 8-90 mL (mean, 26.2 mL). The postoperative hospitalization days were 6-12 days (mean, 7.6 days). All patients were followed up 12-39 months (mean, 25.6 months). Electrocardiogram and chest X-ray film showed that cardiac compression was improved, and symptoms alleviated. At the last follow-up, according to the Nuss standard, the results were excellent in 27 cases, good in 3 cases, and fair in 3 cases, with an excellent and good rate of 90.9%. There was no significant difference in results of effectiveness evaluation among less than 6 years, 6-12 years, and more than 12 years groups (Z= -1.751, P=0.109).
CONCLUSION: Nuss procedure by thoracoscopy has the advantages of little trauma, simple operation, and fast recovery, so it can obtain satisfactory correction of pectus excavatum.