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find Keyword "鸡胸" 11 results
  • 改进微创技术治疗大龄鸡胸患者的近期疗效

    目的 探讨改进微创技术治疗大龄鸡胸患者的可行性及近期结果。 方法 回顾性分析自2009年7月至2011年7月北京军区总医院采用改进微创技术治疗16例大龄鸡胸患者的临床资料,男12例,女4例;年龄(19.8±4.7)岁。鸡胸指数(HI) 2.00±0.23。前胸壁凸起型10例,鸡胸漏斗胸混合型6例。患者仰卧位,在全身麻醉下施行手术。(1)胸骨沉降法:适宜前胸壁凸起型。取胸壁最凸点水平两侧腋中线做小切口,创出横行于前胸壁的胸肌下隧道,将已制备好的矫形板穿过肌下隧道,施压整形后矫形板两端用钢缆与肋骨固定; (2)胸骨抬举及沉降联合法:适宜混合型。用Nuss方法将矫形板置于胸骨最凹陷部位抬举;胸骨角处小切口胸骨截骨和畸形肋软骨切除成形沉降胸骨。 结果 无围术期死亡,16例均顺利完成手术,手术时间(65.0±7.8) min,失血量(20.0±4.2) ml,住院时间(5.0±1.8) d。术后胸廓外形恢复正常,HI 2.8±0.4。胸廓外形和胸部CT影像形状满意。随访 16例,随访时间12~30个月,平均随访18个月。其中1例已取出矫形板。疗效优秀13例(81.2%),良好3例(18.8%)。 结论 采用改进微创技术矫治大龄鸡胸患者,需要选择恰当的手术术式,可获得良好的近期效果。

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • Minimally Invasive Sternal Lowering Operation for the Correction of Pectus Carinatum

    Objective To investigate surgical indications,techniques,safety and clinical outcomes of minimallyinvasive sternal lowering operation for the treatment of pectus carinatum (PC). Methods Clinical data of 40 PC patientswho underwent minimal invasive sternal lowering operation in Xinhua Hospital,School of Medicine,Shanghai Jiao Tong University from July 2009 to August 2012 were retrospectively analyzed. There were 39 male patients and 1 female patientwith their average age of 14.5 (12-22)years. All the patients underwent their surgical correction for the first time,and their chest deformity were characterized by a significant protrusion of the sternum and ribs including 21 symmetric and 19 asymmetric protrusions. Preoperative evaluation included electrocardiogram,CT scan of the chest,echocardiogram and pulmonary function test. Preoperative mean Haller index was 1.91±0.23. Sixteen patients had mild restrictive ventilatory disorder. Allthe patients received minimally invasive sternal lowering operation with a curved Nuss steel bar. Aggravating activities wererestricted within 3 months postoperatively,and the steel bar was removed 2 years later. Results All the operations were completed successfully,and thoracic appearance was significantly improved after correction. All the patients and their relativeswere very satisfied with the corrective outcomes. The operation time was 65-115 (82.0±15.6)minutes and average intraop-erative blood loss was less than 10 ml. Postoperative hospital stay was 3-5 (3.5±0.8) days. Postoperative Haller index was2.39±0.17,which was significantly higher than preoperative Haller index (P<0.01) . Postoperative complications included wound infection in 2 patients,pneumothorax in 1 patient (cured by closed thoracostomy),subcutaneous effusion in 3 patients,and persistent pain (longer than 14 days) in 2 patients. There was no other serious postoperative complication. All the 40 patients were followed up for 3-36 months after discharge. A steel bars was removed ahead of schedule because of wound infection in one patient. Other steel bars were in normal position in 39 patients and there was no displacement of the steel bars or the stabilizers. Eight patients received removal of the steel bars without PC recurrence. Conclusion Juveniles with PC who have good chest wall compliance are the best candidates for minimally invasive sternal lowering operation which is an easy,safe,reliable,minimally invasive and esthetic procedure with satisfactory corrective outcomes.

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
  • THE OUTCOME OF MODIFIED PROCEDURE FOR PECTUS CARINATUM CORRECTION

    Objective To improve the surgical procedure to correctpectus carinatum. Methods From 1990 to 2003, 9 patients with pectus carinatum were treated, whose ages ranged from 3 years and 6 months to 16 years. The conventional operation was performed on 4 patients, the modified procedure on 5 patients. The modified procedure included: ①the shortening rib periosteum was not sutured transversally;② the corrected position of the sternum was stabilized with the metal strut. Results In 4 patients corrected by the conventional procedure, the sternum depression as pectus excavatum occurred in 1 case five years postoperatively. The results were satisfactory in 5 patients corrected by the modified procedure. The reconstructed thorax was symmetrical, without bulging or dimpling of sternum and costal cartilage. Conclusion The improvement of operative method isreasonable and effective in correcting pectus carinatum.

    Release date:2016-09-01 09:29 Export PDF Favorites Scan
  • SURGICAL CORRECTION OF PECTUS CARINATUM

    Over a two year period, four patients of pectus carinatum received surgical correction at our hospital. All patients were followed up for 6 months to 1 year. The operative results were satisfactory but one required revision with additional resection of bilateral second cartilage for the persistent malformation. The clinical characteristics, operative techniques and indications for operative treatment were discussed.

    Release date:2016-09-01 11:38 Export PDF Favorites Scan
  • MINIMALLY INVASIVE PROCEDURE FOR CORRECTION OF PECTUS CARINATUM

    ObjectiveTo explore the method and experience in correction of pectus carinatum with minimally invasive procedure. MethodsBetween June 2010 and January 2014, 30 patients with pectus carinatum were corrected by minimally invasive procedure. There were 21 boys and 9 girls whose average age was 13 years and 2 months (range, from 8 years and 10 months to 18 years and 9 months), including 24 cases of first operation, 2 recurrence after traditional pectus carinatum correction, and 4 cases secondary to median thoracotomy. Thirty patients had symmetric and asymmetric mild pectus carinatum. ResultsThe operation was performed successfully in all patients, and no severe complication occurred. The operation time was 42-95 minutes (mean, 70 minutes). The bleeding volume during operation was 4-30 mL (mean, 10 mL). The time from operation to discharge was 6-10 days (mean, 7 days). The average time of follow-up was 25 months (range, 9-54 months). All surgical wound healed primarily with no infection. The X-ray films showed slight pneumothorax in 7 cases, and it was absorbed after 1 month without treatment. Loosening of internal fixation was found in 1 patient because of trauma at 6 months, and operation was performed again. The bar was removed at 2 years in 21 patients. The patients had good thoracic contour and normal activity. ConclusionMinimally invasive procedure for correction of pectus carinatum is safe and will get satisfactory effect in maintaining thoracic contour. It has also less trauma and shorter operation time.

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  • 微创一期治疗儿童巨大食管裂孔疝合并鸡胸一例

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  • Minimally invasive sternal depression by autologous force for pectus carinatum repair

    Objective To investigate the feasibility and clinical outcomes of minimally invasive sternal depression by autologous force for the correction of pectus carinatum. Methods Between October 2011 and September 2015, 22 pectus carinatum patients underwent minimally invasive surgical correction of pectus carinatum in Tongji Hospital. Clinical data of 22 patients were retrospectively analyzed. There were 19 males and 3 females with a mean age of 12.00±2.87 years, ranging from 6 to 15 years. Among them, 17 patients were symmetric malformation, and the others were asymmetric. Preoperative chest CT scan was performed on 14 patients. Haller index was 1.65-2.23 (1.97±0.15). All the patients underwent the minimally invasive surgical correction of pectus carinatum with a NUSS bar via sternal depression by autologous force. Results All the operations were completed successfully. The mean operation time was 55-120 (83.73±16.62) min and blood loss volume was 10-50 (28.18±11.63) ml. The mean postoperative hospital stay was 3-6 (4.23±1.17) d. Postoperative complications included wound infection in 2 patients, minor pneumothorax in 3 patients, who were cured by conservative treatment. One patient suffering postoperative hydropneumothorax received drainage. All the patients were followed up for 6-48 months after discharge and very satisfied with the chest appearance following surgery. No patient complained of persistent pain. There was no displacement of the bar or the stabilizers. Nine patients underwent the removal of the NUSS bar without pectus carinatum recurrence. Conclusion Minimally invasive sternal depression by autologous force simplifies the procedure of correction of pectus carinatum with reliable and satisfactory outcomes.

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
  • 微创一期治疗儿童鸡胸合并胸骨后疝一例

    Release date:2018-05-02 02:41 Export PDF Favorites Scan
  • Automatic diagnosis of pectus carinatum for children based on the improved Haller index

    Pectus carinatum (PC) is one of the most common chest wall anomalies, which is characterized by the protrusion of the anterior chest wall including the sternum and adjacent costal cartilages. Mildly patients suffer from mental problems such as self-abasement, while severely suffering patients are disturbed by significant cardiopulmonary symptoms. The traditional Haller index, which is widely used clinically to evaluate the severity of PC, is deficient in diagnosis efficiency and classification. This paper presents an improved Haller index algorithm for PC: first, the contour of the patient chest in the axial computed tomography (CT) slice where the most convex thorax presents is extracted; and then a cubic B-spline curve is employed to fit the extracted contour followed by an eclipse fitting procedure; finally, the improved Haller index and the classification index are automatically calculated based on the analytic curves. The results of CT data analysis using 22 preoperative and postoperative patient CT datasets show that the proposed diagnostic index for PC can diagnose and classify PC patients correctly, which confirms the feasibility of the evaluation index. Furthermore, digital measurement techniques can be employed to improve the diagnostic efficiency of PC, achieving one small step towards the computer-aided intelligent diagnosis and treatment for pediatric chest wall malformations.

    Release date:2018-08-23 05:06 Export PDF Favorites Scan
  • Clinical study on minimally invasive weaving technique for pectus carinatum

    ObjectiveTo explore the practical feasibility of the weaving technique for pectus carinatum.MethodsFrom January 2011 to December 2018, a total of 51 patients with pectus carinatum, including 47 males and 4 females at age of 9-29 (13.7±2.9) years, were applied with minimally invasive waving technique for the correction. The steel plate was inserted through the subcutaneous layer, intercostal space and over the sternal surface under direct thoracoscopic vision. The number of implanted steel plates was determined by the degree of chest wall deformity. The steel plate was removed 2 years after surgery.ResultsAll the operations were successfully completed, the average operation time was 63.9±15.8 min, the amount of bleeding was 19.8±8.8 mL, and the duration of postoperative hospitalization was 4.6±1.6 d. The adverse events included intercostal artery injury (n=2), pneumothorax (n=4), pleural effusion (n=3) and skin rupture (n=1). And there were 29 patients of moderate pain (numerical rating scale 4-6 points) on the first day after surgery, but no patient was asked to remove the steel palate due to intolerable discomfort. All patients were followed up after plate placement. Of the 51 patients, the plates were removed in 37 patients until 2 years after placement, and the duration of postoperative hospitalization was 1.4±0.5 d. After 33 (1-48) months of routine follow-up after the removal of the plate, 22 patients achieved excellent outcomes and 9 patients with good outcomes. Besides, there were 5 patients with fair outcome and 1 patient with poor outcome. No adverse effect was found in growth and development after the steel plate placement.ConclusionMinimally invasive weaving technique is a safe, feasible, effective and individualized operation for pectus carinatum with substantial thoracic reconstruction.

    Release date:2019-10-12 01:36 Export PDF Favorites Scan
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