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, 梅舉, 張輔賢, 等. 重度漏斗胸對兒童心肺功能的影響及手術治療效果. 上海交通大學學報(醫學版), 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.	白潔. Nuss微創手術治療漏斗胸的現狀及進展. 中國微創外科雜志, 2015, 15(8): 752-754.
6.	劉鋼, 王平, 黃柳明. 微創漏斗胸矯形術治療漏斗胸53例報告. 中國微創外科雜志, 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, 賈兵, 陳張根, 等. Nuss手術矯治兒童漏斗胸252例臨床分析. 復旦學報(醫學版), 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.	劉文亮, 喻風雷, 尹邦良. 非胸腔鏡輔助改良Nuss手術矯治漏斗胸. 重慶醫科大學學報, 2011, 36(8): 994-996.
17.	劉文亮, 孔德淼, 喻風雷. 胸腔鏡與非胸腔鏡輔助改良Nuss 手術矯治漏斗胸的臨床比較. 中南大學學報(醫學版), 2013, 38(8): 848-852.
18.	劉玉, 鄒志強, 楊露, 等. 非胸腔鏡輔助Nuss手術治療漏斗胸51例分析. 中國胸心血管外科臨床雜志, 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, 梅舉, 張輔賢, 等. 重度漏斗胸對兒童心肺功能的影響及手術治療效果. 上海交通大學學報(醫學版), 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. 白潔. Nuss微創手術治療漏斗胸的現狀及進展. 中國微創外科雜志, 2015, 15(8): 752-754.
6. 劉鋼, 王平, 黃柳明. 微創漏斗胸矯形術治療漏斗胸53例報告. 中國微創外科雜志, 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, 賈兵, 陳張根, 等. Nuss手術矯治兒童漏斗胸252例臨床分析. 復旦學報(醫學版), 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. 劉文亮, 喻風雷, 尹邦良. 非胸腔鏡輔助改良Nuss手術矯治漏斗胸. 重慶醫科大學學報, 2011, 36(8): 994-996.
17. 劉文亮, 孔德淼, 喻風雷. 胸腔鏡與非胸腔鏡輔助改良Nuss 手術矯治漏斗胸的臨床比較. 中南大學學報(醫學版), 2013, 38(8): 848-852.
18. 劉玉, 鄒志強, 楊露, 等. 非胸腔鏡輔助Nuss手術治療漏斗胸51例分析. 中國胸心血管外科臨床雜志, 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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