Liu Qianli, Wang Wenlin, Hong Chun, Liu Wei, Liu Yang, Shang Ziyin, Tang Jing, Liu Cuifen, Liu Yingxing
Department of Pediatric General Thoracic Surgery, Guangdong Women and Children Hospital Guangzhou 511442, Guangdong, China.
Department of Chest Wall Surgery, Guangdong Second People's Hospital Guangzhou 510317, Guangdong, China.
Am J Transl Res. 2022 Jun 15;14(6):3955-3963. eCollection 2022.
To observe the effects of minimally invasive surgical repair of pectus excavatum (NUSS) on the degree of chest flatness, cardiopulmonary function, and bone metabolism indexes in children of various age groups.
In this retrospective study, 62 children with pectus excavatum admitted to our hospital were divided into two groups: group A (3-12 years old) and group B (>12 years old), with 31 cases in each group. All of them were treated with NUSS. The treatment effectiveness, perioperative indexes (operation time, blood loss, ground time, and hospitalization time), degree of chest flatness, cardiopulmonary function, bone metabolism indicators, and complications were compared between the two groups.
There was no significant difference between patients in the two groups in terms of operation time, blood loss, ground time, and hospitalization time (all P>0.05). The overall response rate to treatment in group A (93.55%) was higher than that of group B (70.97%; P<0.05). Three months after the operation, the chest flatness as well as serum alkaline phosphatase and its bone isoform levels in both groups were decreased, while left ventricular ejection fraction, cardiac index, stroke volume, FEV1, and peak expiratory flow levels were increased compared to before the operation, and the improvement in the above indicators of group A was better than Group B (all P<0.05). There was no significant difference in the incidence of complications between the two groups (16.13% 9.68%; P>0.05).
NUSS surgery can achieve satisfactory results in treating children with pectus excavatum at different ages. However, in a certain age range, a younger age indicates a better effect. NUSS procedure effectively improves postoperative flat chest, cardiopulmonary function, and bone metabolism indexes.
观察微创漏斗胸修复术(NUSS)对不同年龄组儿童胸廓扁平程度、心肺功能及骨代谢指标的影响。
在这项回顾性研究中,我院收治的62例漏斗胸患儿分为两组:A组(3 - 12岁)和B组(>12岁),每组31例。所有患儿均接受NUSS治疗。比较两组的治疗效果、围手术期指标(手术时间、出血量、下地时间和住院时间)、胸廓扁平程度、心肺功能、骨代谢指标及并发症情况。
两组患者在手术时间、出血量、下地时间和住院时间方面差异均无统计学意义(均P>0.05)。A组的总体治疗有效率(93.55%)高于B组(70.97%;P<0.05)。术后3个月,两组的胸廓扁平程度以及血清碱性磷酸酶及其骨同工酶水平均降低,而左心室射血分数、心脏指数、每搏输出量、第1秒用力呼气容积(FEV1)和呼气峰值流速水平均较术前升高,且A组上述指标的改善情况优于B组(均P<0.05)。两组并发症发生率差异无统计学意义(16.13%对9.68%;P>0.05)。
NUSS手术在治疗不同年龄段的漏斗胸患儿时均可取得满意效果。然而,在一定年龄范围内,年龄越小效果越好。NUSS手术能有效改善术后胸廓扁平、心肺功能及骨代谢指标。