Fang F-C, Cheng Y-L, Lee S-C, Chen J-C, Hsu H-H, Tzao C
Division of Thoracic Surgery, Department of Surgery, Tri-General Service Hospital, #325 Section 2 Cheng-Kung Road, Nei-Hu, Taipei, Taiwan, Republic of China.
Thorac Cardiovasc Surg. 2008 Aug;56(5):283-6. doi: 10.1055/s-2008-1038631.
Pectus excavatum (PE) repair by Nuss procedure is well established in pediatrics, but studies of adult female patients are rare. We analyzed the efficacy of the Nuss procedure in adult, female PE patients.
We retrospectively reviewed adult patients who underwent Nuss repair of PE from April 2005 to November 2007. Precise morphologic characterization of the pectus allowed an appropriate shaping of the bars to achieve a symmetric repair.
Out of 126 consecutive adult patients who underwent the Nuss procedure at our institution, 15 women with a mean age of 24.6 +/- 4.01 years were enrolled in the study. Their preoperative Haller index had a mean of 5.72 +/- 2.38. Seven patients (46.67 %) underwent repair with the insertion of double pectus bars. Complications included transient bilateral pneumothorax (n = 1) and right-sided pleural effusion (n = 1). One patient received a subsequent breast augmentation, which yielded a better thoracic contour.
The Nuss procedure offers a high satisfaction rate and an acceptable complication rate for PE repair in adult female patients. A subsequent surgery for breast augmentation can be considered after the Nuss repair has stabilized.
在儿科，通过努斯手术修复漏斗胸（PE）已得到充分确立，但针对成年女性患者的研究却很少。我们分析了努斯手术在成年女性PE患者中的疗效。
我们回顾性分析了2005年4月至2007年11月期间接受PE努斯修复术的成年患者。对漏斗胸进行精确的形态学特征分析，以便对钢板进行适当塑形，实现对称修复。
在我们机构连续接受努斯手术的126例成年患者中，15名女性纳入研究，平均年龄为24.6±4.01岁。她们术前的哈勒指数平均为5.72±2.38。7例患者（46.67%）通过插入双漏斗胸钢板进行修复。并发症包括短暂性双侧气胸（n = 1）和右侧胸腔积液（n = 1）。1例患者随后接受了隆胸手术，使胸廓轮廓更佳。
努斯手术在成年女性患者的PE修复中具有较高的满意度和可接受的并发症发生率。在努斯修复稳定后可考虑进行隆胸后续手术。
