Becmeur François, Ferreira Cindy Gomes, Haecker Frank-Martin, Schneider Anne, Lacreuse Isabelle
Department of Pediatric Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
J Laparoendosc Adv Surg Tech A. 2011 Oct;21(8):757-61. doi: 10.1089/lap.2011.0035. Epub 2011 Sep 1.
We present a new case of cardiac perforation during retrosternal dissection beginning a Nuss procedure for pectus excavatum repair in an 18-year-old boy. The true incidence of life-threatening complications, such as heart injuries during Nuss bar placement for pectus excavatum repair, as well as cardiac lacerations during removal of the bar, remains unknown. Many papers suggest measures to prevent these complications: approaching the retrosternal space through an additional subxiphoid short incision, lifting the sternum during bar placement, or placing the bar extrapleuraly. Nuss procedure is gaining more and more popularity due to its apparent simplicity; however, its operational complications should be well known and discussed to be avoided later on.
我们报告了一例18岁男孩在为修复漏斗胸开始进行Nuss手术的胸骨后解剖过程中发生心脏穿孔的新病例。对于漏斗胸修复手术中放置Nuss棒时发生心脏损伤以及取出棒时发生心脏撕裂等危及生命并发症的真实发生率仍不清楚。许多论文提出了预防这些并发症的措施：通过额外的剑突下短切口进入胸骨后间隙、放置棒时抬起胸骨或在胸膜外放置棒。由于其明显的简便性，Nuss手术越来越受欢迎；然而，其手术并发症应广为人知并进行讨论，以免日后出现。
