Kim Hyun Koo, Choi Young Ho, Cho Yang Hyun, Ryu Se Min, Sohn Young-sang, Kim Hark Jei
Department of Thoracic and Cardiovascular Surgery, Guro Hospital, Korea University Medical Center, 97 Guro-donggil, Guro-gu, Seoul, Korea.
J Korean Med Sci. 2007 Apr;22(2):254-7. doi: 10.3346/jkms.2007.22.2.254.
We evaluated the safety and stability of the less-invasive submuscular bar fixation method in the Nuss procedure. One hundred and thirteen patients undergoing the Nuss procedure were divided into three groups according to the bar fixation technique employed. Group 1 consisted of 25 patients who had undergone bilateral pericostal bar fixation, group 2 consisted of 39 patients with unilateral pericostal one, and group 3 included 49 patients with bilateral submuscular one. The patients' age ranged from 2 to 25 yr, with an average of 7.2+/-5.67 yr. Bar dislocation occurred in 1 patient (4%) in Group 1, 2 patients (5.1%) in Group 2, and 1 patient (2.0%) in Group 3 (p=0.46). Hemothorax was noted in 2 patients (8%) in Group 1, 2 (5.1%) in Group 2, and none (0%) in Group 3 (Group 1 vs. Group 3, p=0.028). The mean operation time was shorter in Group 3 than Group 1 (50.1+/-21.00 in Group 3 vs. 67.2+/-33.07 min in Group 1, p=0.041). The submuscular bar fixation results in a decrease in technique-related complications and operation time and is associated with favorable results with regard to the prevention of bar dislodgement.
我们评估了努斯手术中微创肌下棒固定方法的安全性和稳定性。113例行努斯手术的患者根据所采用的棒固定技术分为三组。第1组由25例行双侧肋骨周围棒固定的患者组成，第2组由39例行单侧肋骨周围棒固定的患者组成，第3组包括49例行双侧肌下棒固定的患者。患者年龄范围为2至25岁，平均为7.2±5.67岁。第1组有1例患者（4%）发生棒移位，第2组有2例患者（5.1%），第3组有1例患者（2.0%）（p = 0.46）。第1组有2例患者（8%）出现血胸，第2组有2例（5.1%），第3组无（0%）（第1组与第3组比较，p = 0.028）。第3组的平均手术时间比第1组短（第3组为50.1±21.00分钟，第1组为67.2±33.07分钟，p = 0.041）。肌下棒固定可减少技术相关并发症和手术时间，并且在预防棒移位方面有良好效果。
