非胸腔镜辅助Nuss手术治疗漏斗胸

Non-thoracoscopic assisted Nuss surgery in treatment of pectus excavatum

目的探讨非胸腔镜辅助下Nuss手术矫治漏斗胸的初步经验。方法 2008年5月～2012年2月笔者所在科室采用非胸腔镜辅助的Nuss手术矫治漏斗胸25例,年龄3～19岁,均在非胸腔镜辅助下完成,部分胸骨凹陷较重病例剑突下小切口辅助完成,24例为对称型,1例为非对称型。结果 25例均顺利完成手术,无术中并发症,手术时间35～60min,术中出血量为<20mL,术后平均住院时间(7.5±3.0)d,无一例输血,术后随访1～15个月,除2例间歇性疼痛,2例少量气胸外,其余无特殊不适,无钢板移位,矫形效果23例优,2例良。结论非胸腔辅助下的Nuss手术创伤小,手术时间短,恢复快,安全有效。

Objective To investigate the initial experience of non-thoracoscopic assisted Nuss surgery in the correction of pectus excavatum. Methods Twenty-five patients, 3 to 19 years old, who received non-thoracoscopic assisted Nuss surgery for the correction of pectus excavatum from May 2008 to February 2012 in the author＇s department were selected. All the patients were operated with the non-thoracoscopic assistance, of which some patients with severe koilosternia were assisted with the subxiphoid small incision. Twenty-four cases were symmetric and one case was asymmetric. Results All the 25 patients were successfully operated, with no intraoperative complications, operative time of 35 to 60 minutes, intraoperative blood loss 〈 20 mL, average postoperative hospital stay of （7.5± 3.0） days and no blood transfucion. After 1 to 15 months of follow-up, except 2 cases of intermittent pain and 2 cases of smM1 pneumothorax, the rest patients showed no special discomfort or steel plate displacement. Regarding to the orthopedic effects, 23 cases were excellent and 2 were fine. Conclusion Non-thoracoscopic assisted Nuss surgery has small operative trauma, shorter operative time and fast recovery, and is safe and effective.