Department of Pediatric Surgery, Chang Gung Children's Hospital, Chang Gung University, Taoyuan 33332, Taiwan.
J Pediatr Surg. 2009 Dec;44(12):2287-90. doi: 10.1016/j.jpedsurg.2009.07.048.
The length of the bar used for the Nuss procedure is typically determined by measuring the distance between the 2 midaxillary lines and subtracting 2.5 cm. However, this may not be accurate for all patients. Measurements of the chest using computed tomography (CT) were developed for better determination of bar length.
Seventy-five patients underwent the Nuss procedure between 2005 and 2008. The length and curve of the pectus bar were determined using both the traditional method (TM) and CT.
Twelve patients (16%) had length differences (LD) with the methods. The LD and non-LD patients were 18.8 +/- 2.4 and 11.3 +/- 0.6 years old, respectively (P = .005). The proportion of females in the groups was 58.3% (7/12) and 28.6% (18/63), respectively (P = .046). The TM gave a longer bar estimation in all but one patient with a high sternal angulation. Slight bar protrusion was noted in 3 of the 12 patients with LD using TM and 0 of the 9 patients using CT.
Computed tomography measurement is a precise means for determining length, especially in older patients, females with developed breasts, or patients with high sternal angulation. It also allows for better curvature design, preventing multiple intraoperative adjustments.
Nuss 手术中使用的支撑杆的长度通常通过测量两条腋中线之间的距离，然后减去 2.5 厘米来确定。然而，对于所有患者来说，这可能并不准确。使用计算机断层扫描（CT）对胸部进行测量是为了更准确地确定支撑杆的长度。
2005 年至 2008 年间，75 例患者接受了 Nuss 手术。使用传统方法（TM）和 CT 对胸壁支撑杆的长度和曲线进行了测量。
12 例患者（16%）两种方法测量的长度存在差异（LD）。LD 患者和非 LD 患者的年龄分别为 18.8 +/- 2.4 岁和 11.3 +/- 0.6 岁（P =.005）。两组中女性的比例分别为 58.3%（7/12）和 28.6%（18/63）（P =.046）。除了一个胸骨角较高的患者外，TM 方法在所有患者中都给出了较长的支撑杆估计值。使用 TM 方法，12 例 LD 患者中有 3 例出现轻微支撑杆突出，而使用 CT 方法的 9 例患者中无一例出现这种情况。
CT 测量是确定长度的一种精确方法，特别是在年龄较大的患者、乳房发育良好的女性或胸骨角较高的患者中。它还可以更好地设计曲率，防止多次术中调整。
