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漏斗胸Nuss术后矫形钢板改良取出技术临床应用的观察分析 被引量:3

Clinical analysis of modified technique for pectus bar removal after Nuss procedure
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摘要 目的:探讨Nuss手术矫治漏斗胸后应用改良技术取出矫形钢板的可行性及安全性。方法:回顾性总结2008年12月至2012年2月漏斗胸矫形钢板取出患者资料共186例。所有病例仅切开右侧原手术切口(Nuss手术固定片安装在右侧)。全身麻醉,单腔气管插管或喉罩,患者仰卧位,采用改良钢板取出技术,术中矫形钢板无需扳直或翻转。结果:Nuss手术后2年取出钢板132例(71.0%),2年半以上53例(28.5%),1年以内1例(0.5%)。钢板取出手术时间9~20(13.1±3.4)min;术中出血量3~20(5.2±2.7)mL。术后无胸腔内活动性出血,无切口感染;术后右侧少量气胸3例(1.6%)。术后住院时间均为1 d。186例随访4~48(21.4±6.8)个月,漏斗胸复发1例(0.5%)。结论:Nuss手术后2年或更长时间可经单一右侧原切口,采用改良技术取出矫形钢板,不需翻转以及扳直钢板,具有简单、可行、安全的优点。 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) rain, 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 showedinfection 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.
出处 《中南大学学报(医学版)》 CAS CSCD 北大核心 2013年第3期274-278,共5页 Journal of Central South University :Medical Science
关键词 漏斗胸 钢板取出 NUSS手术 pectus excavatum bar removal Nuss operation
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参考文献18

  • 1Nuss D, Kelly RJ, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum [J]. J Pediatr Surg, 1998, 33(4): 545-552.
  • 2Nuss D, Kelly RE Jr. Indications and technique of Nuss procedure for pectus excavatum[J]. Thorac Surg Clin, 2010, 20(4): 583-597.
  • 3Croitoru DP, Kelly RE, Goretsky MJ, et al. Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients[J].J Pediatr Surg, 2002, 37(3): 437-445.
  • 4Kelly RE, Goretsky 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): 1072- 1081.
  • 5Han Y, Wang J, Li W, et al. Non-thoracoscopic extrapleural Nuss procedure for the correction of pectus excavatum in children[J]. Eur J Cardiothorac Surg, 2010, 37(2): 312-325.
  • 6Yoon YS, Kim HK, Choi YS, et al. A modified Nuss procedure for late adolescent and adult pectus excavatum[J]. World J Surg, 2010, 34(7): 1475-1480.
  • 7St Peter SD, Sharp SW, Ostlie DJ, et al. Use ofa subxiphoid incision for pectus bar placement in the repair of pectus excavatum[J]. J Pediatr Snrg, 2010, 45(6): 1361-1364.
  • 8Park HJ, Jeong JY, Jo WM, et al. Minimally invasive repair of pectus excavatum: a novel morphology-tailored, patient-specific approach[J]. J Thorac Cardiovasc Surg, 2010, 139 (2): 379-386.
  • 9Noguchi M, Fujita K. A new technique for removing the pectus bar used in the Nuss procedure[J].J Pediatr Surg, 2005, 40(4): 674-677.
  • 10St Peter SD, Sharp RJ, Upadhyaya P, et al. A straight forward technique for removal of the substernal bar after the Nuss operation [J]. J Pediatr Surg, 2007, 42(10): 1789-1791.

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