Poola Ashwini Suresh, Rentea Rebecca M, Weaver Katrina L, St Peter Shawn David
Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Pediatr Surg Int. 2017 May;33(5):619-622. doi: 10.1007/s00383-017-4057-8. Epub 2017 Mar 4.
While there is literature on techniques for pectus bar removal, there are limited reports on post-operative management. This can include obtaining a postoperative chest radiograph (CXR) despite the minimal risk of associated intra-thoracic complications. This is a review of our experience with bar removal and lack of routine post-operative CXR.
A single institution retrospective chart review was performed from 2000 to 2015. Patients who underwent a pectus bar removal procedure were included. We assessed operative timing of bar placement and removal, procedure length, intra-operative and post-operative complications and post-operative CXR findings, specifically the rate of pneumothoraces.
450 patients were identified in this study. Median duration of bar placement prior to removal was 35 months (interquartile range 30 and 36 months). Sixtey-four patients obtained a post-operative CXR. Of these, only one (58%) film revealed a pneumothorax; this was not drained. A CXR was not obtained in 386 (86%) patients with no immediate or delayed complications from this practice. Median follow-up time for all patients was 11 months (interquartile range 7.5-17 months).
The risk for a clinically relevant pneumothorax is minimal following bar removal. This suggests that not obtaining routine imaging following bar removal may be a safe practice.
虽然有关于鸡胸矫正棒取出技术的文献，但关于术后管理的报道有限。这可能包括尽管胸内相关并发症风险极小，但仍需进行术后胸部X光检查（CXR）。这是一篇关于我们鸡胸矫正棒取出经验以及未进行常规术后胸部X光检查情况的综述。
对2000年至2015年期间一家机构的病历进行回顾性研究。纳入接受鸡胸矫正棒取出手术的患者。我们评估了矫正棒放置和取出的手术时间、手术时长、术中及术后并发症以及术后胸部X光检查结果，特别是气胸发生率。
本研究共纳入450例患者。取出矫正棒前的中位放置时间为35个月（四分位间距为30至36个月）。64例患者进行了术后胸部X光检查。其中，只有一张（58%）片子显示有气胸；未进行引流。386例（86%）患者未进行胸部X光检查，且此做法未导致即刻或延迟并发症。所有患者的中位随访时间为11个月（四分位间距为7.5至17个月）。
鸡胸矫正棒取出后发生具有临床意义的气胸风险极小。这表明取出矫正棒后不进行常规影像学检查可能是一种安全的做法。
