胸腔镜辅助下Nuss术治疗漏斗胸的体会

The experiment of the Nuss procedure with the thoracoscope assist for funnel chest

目的:总结胸腔镜辅助下微创漏斗胸(Nuss手术)的治疗经验。方法:回顾分析2007年6月～2011年5月12例采用胸腔镜辅助下微创漏斗胸患者的临床资料,其中男9例,女3例,年龄8岁9个月～26岁,平均(18.7±4.5)岁。根据漏斗胸的畸形状况:对称型采用了传统Nuss手术;非对称型采用个性化钢板设计的胸腔镜辅助下微创手术方法。结果:全组患者对称型占75%(9/12),非对称型25%(3/12),所有病例均顺利完成手术,手术时间26～115 min,术中出血量20～80 ml,住院时间5～10 d。随访1～35个月,1例术后支架下滑移位导致复发,经再次手术后康复,其余患者无复发及再手术。结论:胸腔镜辅助下微创漏斗胸手术具有技术可靠、创伤小、术后恢复快,非对称型个性化钢板设计扩大了该手术适应证。

Objective To investigate the clinical experiment of the Nuss procedure with the thoracoscope assist for funnel chest. Method The clinic data of 12 patients who underwent repair of funnel chest by the Nuss procedure with the thoracoscope assist from June 2007 to May 2011 were reviewed retrospectively. There were 9 male and 3 female patients. The age ranged from 8 years and 9 months old to 26 years old, with a mean of（ 18.7 ± 4. 5 ）years old. According to the morphology of the funnel chest, The patients of symmetric type were all received original Nuss procedure, and none symmetric types underwent the procedure using characteristic Steel design and technical modification. Results Among the 12 patients, 9 patients （ 75 % ） were symmetric funnel chest, and 3 patients （ 25 % ） were none symmetric type. All the patients underwent the procedure successfully. The total time of the procedure ranged from 26 to 115 rain. Volume of blood loss ranged from 20 to 80 ml. All patients were in the hospital ranged from 5 to 10 days. All patients were followed up ranged from 1 month to 35 months, and the results of the repair were excellent in 11 patients. Only one patient received a further operation. Conclusion The technology of Nuss procedure with the thoracoscope assist is reliable ,less trauma and fast recovery. Funnel chest of none symmetric type with character- istic steel design and technical modification extends the operation indication.