Uniportal Procedure for the Correction of Pectus Excavatum in 203 Patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CAORui ¹ ,  WANGQiang ² , WUYong ² , WANLai-yi ¹ , ZENGGuang ¹ , XUWen-ju ¹ , PENGShou-xing ² , XIAOMing-di ²

1. Xinxiang Medical University, Xinxiang 453003 Henan, P. R. China;
2. Department of Thoracic Surgery, Shanghai Yodak Cardiothoracic Hospital, Shanghai 200235, P. R. China;

Corresponding author：

WANGQiang, Email: doctor95@126.com

Keywords：

Uniportal procedure; Pectus excavatum; Nuss procedure

DOI：

10.7507/1007-4848.20160273

Video：

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Objective To summarize the clinical experience and investigate the safety and reliability of uniportal procedure for the correction of pectus excavatum (PE). Methods From November 2010 to November 2015, 203 PE patients (164 males, 39 femalzs average age of 5.7±3.0 years, ranging from 2 to 19 years) underwent the correction operation with only single 2 cm incision on right lateral chest. There were 188 patients under 12 years of age and 15 patients above 12 years. According to Park classification, 176 patients were symmetric and 27 were asymmetric. Results All operations were performed successfully. The average operating time was 16.1±5.2 min with a range of 4-65 min and the average postoperative hospital stay was 6.4±1.3 d, ranging from 4-14 d. A single incision was made on the right chest and only one bar was inserted in the patients. Postoperative follow-up was 1-56 months (mean, 27.6 months). There was no complication occurred such as bar turnover, displacement and redepressed sternum. Totally, 84 patients received bar removal procedure. Conclusion In terms of operation time and surgical trauma, uniportal procedure for PE is superior to Nuss procedure. And there is no significant difference in the safety and effectiveness between two procedures. Uniportal procedure is especially suitable for the treatment of PE children under 12 years of age.

Citation： CAORui, WANGQiang, WUYong, WANLai-yi, ZENGGuang, XUWen-ju, PENGShou-xing, XIAOMing-di. Uniportal Procedure for the Correction of Pectus Excavatum in 203 Patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(12): 1158-1161. doi: 10.7507/1007-4848.20160273 Copy

1.	Nuss D, Kelly RE, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg, 1998, 33(4): 545-552.
2.	Guntheroth WG, Spiers PS. Cardiac function before and after surgery for pectus excavatum. Am J Cardiol, 2007, 99(12): 1762-1764.
3.	肖海波, 梅举, 张辅贤, 等. 重度漏斗胸对儿童心肺功能的影响及手术治疗效果. 上海交通大学学报(医学版), 2009, 29(9): 1092-1094.
4.	Kuru P, Bostanci K, Ermerak NO, et al. Quality of life improves after minimally invasive repair of pectus excavatum. Asian Cardiovasc Thorac Ann, 2015, 23(3): 302-307.
5.	白洁. Nuss微创手术治疗漏斗胸的现状及进展. 中国微创外科杂志, 2015, 15(8): 752-754.
6.	刘钢, 王平, 黄柳明. 微创漏斗胸矫形术治疗漏斗胸53例报告. 中国微创外科杂志, 2006, 6(3): 207-209.
7.	Kelly RE, Goretsky MJ, Obermeyer R, et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1 215 patients. Ann Surg, 2010, 252(6): 1072-1081.
8.	Hebra A, Gauderer MW, Tagge EP, et al. A simple technique for preventing bar displacement with the Nuss repair of pectus excavatum. J Pediatr surg, 2001, 36(8): 1266-1268.
9.	Uemura S, Nakagawa Y, Yoshida A, et al. Experience in 100 patients with the Nuss procedure using a technique for stabilization of the pectus bar. J Pediatr Surg Int, 2003, 19(3): 186-189.
10.	Park HJ, Kim KS, Lee S, et al. A next-generation pectus excavatum repair technique new devices make a difference. Ann Thorac Surg, 2015, 99(2): 455-461.
11.	Casamassima MG, Goldstein SD, Salazar JH, et al. Perioperative strategies and technical modification to the Nuss repair for pectus excavatum in pediatric patient: a large volume,single institution experience. J Pediatr Surg, 2014, 49(4): 575-582.
12.	陶麒麟, 贾兵, 陈张根, 等. Nuss手术矫治儿童漏斗胸252例临床分析. 复旦学报(医学版), 2013, 40(3): 319-322.
13.	Clark JJ, Johnson SM. Single incision Nuss procedure for pectus excavatum. Pediatr Surg Int, 2011, 27(7): 733-736.
14.	Palmer B, Yedlin S, Kim S. Decreased risk of complications with bilateral thoracoscopy and left-to-right mediastinal dissection during minimally invasive repair of pectus excavatum. Eur J Pediatr Surg, 2007, 17(2): 81-83.
15.	Han Y, Wang J, Li W, et al. Non-thoracoscopic extrapleural Nuss procedure for the correction of pectus excavatum in children. Eur J Cardiothorac Surg, 2010, 37(2): 312-315.
16.	刘文亮, 喻风雷, 尹邦良. 非胸腔镜辅助改良Nuss手术矫治漏斗胸. 重庆医科大学学报, 2011, 36(8): 994-996.
17.	刘文亮, 孔德淼, 喻风雷. 胸腔镜与非胸腔镜辅助改良Nuss 手术矫治漏斗胸的临床比较. 中南大学学报(医学版), 2013, 38(8): 848-852.
18.	刘玉, 邹志强, 杨露, 等. 非胸腔镜辅助Nuss手术治疗漏斗胸51例分析. 中国胸心血管外科临床杂志, 2015, 22(2): 139-142.
19.	Scott E, Fred R, Karen W, et al. Is the grass greener? Early results of Nuss procedure. J Pediatr Surg, 2000, 35(2): 246-251.

1. Nuss D, Kelly RE, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg, 1998, 33(4): 545-552.
2. Guntheroth WG, Spiers PS. Cardiac function before and after surgery for pectus excavatum. Am J Cardiol, 2007, 99(12): 1762-1764.
3. 肖海波, 梅举, 张辅贤, 等. 重度漏斗胸对儿童心肺功能的影响及手术治疗效果. 上海交通大学学报(医学版), 2009, 29(9): 1092-1094.
4. Kuru P, Bostanci K, Ermerak NO, et al. Quality of life improves after minimally invasive repair of pectus excavatum. Asian Cardiovasc Thorac Ann, 2015, 23(3): 302-307.
5. 白洁. Nuss微创手术治疗漏斗胸的现状及进展. 中国微创外科杂志, 2015, 15(8): 752-754.
6. 刘钢, 王平, 黄柳明. 微创漏斗胸矫形术治疗漏斗胸53例报告. 中国微创外科杂志, 2006, 6(3): 207-209.
7. Kelly RE, Goretsky MJ, Obermeyer R, et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1 215 patients. Ann Surg, 2010, 252(6): 1072-1081.
8. Hebra A, Gauderer MW, Tagge EP, et al. A simple technique for preventing bar displacement with the Nuss repair of pectus excavatum. J Pediatr surg, 2001, 36(8): 1266-1268.
9. Uemura S, Nakagawa Y, Yoshida A, et al. Experience in 100 patients with the Nuss procedure using a technique for stabilization of the pectus bar. J Pediatr Surg Int, 2003, 19(3): 186-189.
10. Park HJ, Kim KS, Lee S, et al. A next-generation pectus excavatum repair technique new devices make a difference. Ann Thorac Surg, 2015, 99(2): 455-461.
11. Casamassima MG, Goldstein SD, Salazar JH, et al. Perioperative strategies and technical modification to the Nuss repair for pectus excavatum in pediatric patient: a large volume,single institution experience. J Pediatr Surg, 2014, 49(4): 575-582.
12. 陶麒麟, 贾兵, 陈张根, 等. Nuss手术矫治儿童漏斗胸252例临床分析. 复旦学报(医学版), 2013, 40(3): 319-322.
13. Clark JJ, Johnson SM. Single incision Nuss procedure for pectus excavatum. Pediatr Surg Int, 2011, 27(7): 733-736.
14. Palmer B, Yedlin S, Kim S. Decreased risk of complications with bilateral thoracoscopy and left-to-right mediastinal dissection during minimally invasive repair of pectus excavatum. Eur J Pediatr Surg, 2007, 17(2): 81-83.
15. Han Y, Wang J, Li W, et al. Non-thoracoscopic extrapleural Nuss procedure for the correction of pectus excavatum in children. Eur J Cardiothorac Surg, 2010, 37(2): 312-315.
16. 刘文亮, 喻风雷, 尹邦良. 非胸腔镜辅助改良Nuss手术矫治漏斗胸. 重庆医科大学学报, 2011, 36(8): 994-996.
17. 刘文亮, 孔德淼, 喻风雷. 胸腔镜与非胸腔镜辅助改良Nuss 手术矫治漏斗胸的临床比较. 中南大学学报(医学版), 2013, 38(8): 848-852.
18. 刘玉, 邹志强, 杨露, 等. 非胸腔镜辅助Nuss手术治疗漏斗胸51例分析. 中国胸心血管外科临床杂志, 2015, 22(2): 139-142.
19. Scott E, Fred R, Karen W, et al. Is the grass greener? Early results of Nuss procedure. J Pediatr Surg, 2000, 35(2): 246-251.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Uniportal Procedure for the Correction of Pectus Excavatum in 203 Patients

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