Zhang Xuefeng, Hu Fengqing, Bi Rui, Wang Lei, Jiang Lianyong
Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Thorac Dis. 2022 Aug;14(8):2781-2790. doi: 10.21037/jtd-22-189.
Currently, the anti-Nuss operation is widely used as standard surgery for pectus carinatum, but the installation and removal of the Nuss steel bars can be difficult, time-consuming and traumatic. To further simplify the procedure, we designed a new steel bar to facilitate minimally invasive surgical correction of pectus carinatum.
From January 2018 to July 2021, 112 patients underwent minimally invasive repair of pectus carinatum (MIRPC) with the new steel bar in our centre. Two generations of bars were designed during our study period, and symmetric and asymmetric deformities were treated. After 2 years of follow-up, the bar and stabilizers were removed. The effects and complications of minimally invasive repair using the new bar to correct pectus carinatum were reviewed.
The mean patient age was 14.46 years. The mean operation duration was 67.74 minutes. The mean hospital length of stay was 3.64 days. The Haller index of the patients improved from 1.96 preoperatively to 2.78 postoperatively. The complications included pneumothorax, pleural effusion, wound infections, nickel allergy, screw loosening, wire breakdown, bar fraction and overcorrection leading to excavatum. Seventy-two patients (64.3%) underwent bar removal, with 63 patients (87.5%) achieving excellent or good results. The deformity recurred in 2 patients (2.8%) during follow-up.
MIRPC with our newly designed steel bar can achieve good results and is effective in repairing both symmetric and asymmetric carinatum deformities.
目前，反努氏手术被广泛用作鸡胸的标准手术，但努氏钢条的安装和拆除可能困难、耗时且具有创伤性。为进一步简化手术过程，我们设计了一种新型钢条，以促进鸡胸的微创外科矫正。
2018年1月至2021年7月，112例患者在我们中心接受了使用新型钢条的鸡胸微创修复术（MIRPC）。在我们的研究期间设计了两代钢条，并治疗了对称和不对称畸形。随访2年后，取出钢条和固定器。回顾了使用新型钢条进行鸡胸微创修复的效果和并发症。
患者平均年龄为14.46岁。平均手术时间为67.74分钟。平均住院时间为3.64天。患者的哈勒指数从术前的1.96提高到术后的2.78。并发症包括气胸、胸腔积液、伤口感染、镍过敏、螺钉松动、钢丝断裂、钢条断裂和过度矫正导致漏斗胸。72例患者（64.3%）接受了钢条取出，其中63例患者（87.5%）取得了优良效果。随访期间有2例患者（2.8%）出现畸形复发。
使用我们新设计的钢条进行鸡胸微创修复术可取得良好效果，对对称和不对称鸡胸畸形均有效。
