复发性漏斗胸的超微创外科治疗

Minimally invasive surgery with novel modified Nuss procedure for treatment of recurrent pectus excavatum

目的总结应用超微创矫形钢板治疗复发性漏斗胸的治疗经验。方法回顾性分析从2010年1月—2017年12月126例采用自主产权的超微创矫形钢板治疗复发性漏斗胸的临床资料,并对治疗效果进行随访,对术前术后的Haller指数及肺功能指标进行对比分析。结果126例患者矫形效果满意,均痊愈出院。其中8例置入两根钢板,2例术后出现钢板移位,再次手术后效果良好,88例已经行钢板拆除术,未再次复发。外观明显改善:Haller指数从术前的4.83±0.76改善成术后的2.38±0.91。肺通气功能改善明显:FEV1从术前的(53.9±8.18)%改善成术后的(76.4±6.73)%。结论应用超微创矫形钢板治疗复发性漏斗胸,联合肋间固定加强,可有效改善胸廓形态,解除压迫,改善肺功能,安全便捷,效果良好。

Objective To explore the feasibility and efficacy of novel modified Nuss procedure in treatment of recurrent pectus excavatum.Methods Clinical data of 126 patients with recurrent pectus excavatum treated by novel modified procedure from January 2010 to December 2017 were retrospectively analyzed.The Haller Index and pulmonary function were compared before and after operation.Results The procedures were all successfully completed in 126 patients.In 8 cases 2 steel bars were placed during the procedure,the bar displacement occurred in 2 cases who underwent operation again and discharged with cure.The steel bars were removed in 88 patients and there was no recurrence.The appearance of the thorax was significantly improved in all patients,the Haller Index was decreased from 4.83±0.76 preoperatively into 2.38±0.91 after the operation.Lung ventilation was significantly improved,FEV1 was increased from(53.9±8.18)%before the operation to(76.4±6.73)%after the procedure.Conclusion The novel modified Nuss procedure is safe and feasible for treatment of recurrent pectus excavatum.