Department of Cardiothoracic Surgery, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
Eur J Cardiothorac Surg. 2011 Jun;39(6):1040-2. doi: 10.1016/j.ejcts.2010.10.002. Epub 2010 Nov 13.
Very few data are available on complications following elective bar removal after the Nuss procedure for pectus excavatum. The objective of this study was to investigate the data from 343 consecutive patients.
From 2003 to 2009, 343 patients (85% males) had their pectus bar removed. Nine patients were excluded because of bar removal within the first year after implantation. Data were recorded from hospital records regarding: operation time, formation of callus around the bar, unilateral or bilateral incision, complications, postoperative hospital stay and if a senior resident or an intern performed the operation.
The median age at the time of bar removal was 19.1 years. The median time for removal after insertion of the bar was 1139 days (range 641-2575 days). The median operation time was 34 min (range 5-183 min). The operation time depended on the formation of callus around the bar (p<0.0001), numbers of bars to be removed (p<0.0002), the need for bilateral incision (p<0.0001) and the charge of the surgeon performing the operation (p<0.0008). Eight patients (2.4%) had complications after the surgery. Five patients had pneumothorax, of which three were treated with chest tubes, and two controlled with chest X-ray. Three patients had hemothorax. Two were treated with a chest tube and the third required open surgery. Most of the patients were discharged on the day of surgery (94%) or the day after surgery (4%). Only six (2%) required more than a single day of hospitalization.
Bar removal following the Nuss procedure is a quick and safe operation with very few complications. Occurrence of complications is not dependent on the experience of the surgeon.
对于漏斗胸 Nuss 手术后择期取出矫正板，目前仅有少量数据涉及相关并发症。本研究旨在分析 343 例连续患者的数据。
2003 年至 2009 年，343 例患者（85%为男性）接受了矫正板取出术。9 例因植入后 1 年内取出矫正板而被排除。从病历中记录手术时间、矫正板周围骨痂形成、单侧或双侧切口、并发症、术后住院时间以及由高级住院医师或实习医师进行手术等数据。
矫正板取出时的中位年龄为 19.1 岁。矫正板植入后中位取出时间为 1139 天（641-2575 天）。中位手术时间为 34 分钟（5-183 分钟）。手术时间取决于矫正板周围骨痂形成（p<0.0001）、需取出的矫正板数量（p<0.0002）、是否需要双侧切口（p<0.0001）和手术医生的费用（p<0.0008）。8 例（2.4%）患者术后出现并发症。5 例发生气胸，其中 3 例经胸腔引流管治疗，2 例经 X 线胸片控制。3 例发生血胸。2 例经胸腔引流管治疗，第 3 例需行开胸手术。大多数患者于手术当天（94%）或次日（4%）出院。仅有 6 例（2%）需要住院超过 1 天。
Nuss 手术后矫正板取出是一种快速、安全的手术，并发症很少。并发症的发生与手术医生的经验无关。
