Department of Pediatric Allergy, Children's Hospital, University of Bonn, Bonn, Germany.
Department of Pediatric Surgery, Children's Hospital, University of Bonn, Bonn, Germany.
J Pediatr Surg. 2023 Sep;58(9):1674-1678. doi: 10.1016/j.jpedsurg.2023.02.057. Epub 2023 Feb 28.
We aimed to determine the longitudinal changes in pulmonary functions of adolescents with Pectus Excavatum who underwent the Nuss procedure, the minimally invasive repair of pectus excavatum (MIRPE).
Lung function measurements were performed before bar implantation (T), at least six weeks to ten months after implantation (T), at least eleven months to sixty-one months after bar implantation (T) and at least two weeks after bar explantation (T).
Data of 114 patients (83.3% male) whose median age at implantation was 15.6 years and at explantation 18.7 years were analyzed. Shortly after implantation at T a significant decline of vital capacity (VC; n = 82), forced vital capacity (FVC; n = 78) and forced expiratory volume in 1 second (FEV; n = 80) compared to T was seen. At T a significant decline for the residual volume (RV; n = 83), the residual volume/total lung capacity ratio (RV/TLC; n = 81), the total specific airway resistance (sRaw; n = 80) and the total airway resistance (Raw; n = 84) also compared to T was measured. In the comparison of T to T a significant increase of VC, FVC (n = 67), FEV (n = 69), TLC (n = 67) and a significant decrease of Raw (n = 66), sRaw, RV (n = 65) and the RV/TLC (n = 64) ratio could be observed. In the direct analysis between T and T, after the explantation of the bar a significant increase in VC (n = 54), FVC (n = 52), and TLC (n = 55) and a significant decrease of RV (n = 51) and the RV/TLC index (n = 50), and in airway resistance parameters like Raw (n = 52) and sRaw (n = 51) could be detected.
Lung function values along with markers of airway resistance improve in patients after the complete procedure of MIRPE.
Level II.
我们旨在确定接受微创修复漏斗胸（MIRPE）的漏斗胸青少年患者在植入 Nuss 杆后肺功能的纵向变化。
在植入杆前（T 期）、植入后至少 6 周到 10 个月（T 期）、植入后至少 11 个月到 61 个月（T 期）和植入后至少 2 周（T 期）时进行肺功能测量。
分析了 114 名患者（83.3%为男性）的数据，他们的植入中位年龄为 15.6 岁，取出中位年龄为 18.7 岁。在 T 期，与 T 期相比，肺活量（VC；n=82）、用力肺活量（FVC；n=78）和 1 秒用力呼气量（FEV；n=80）均显著下降。在 T 期，与 T 期相比，残气量（RV；n=83）、残气量/肺总量比（RV/TLC；n=81）、总特异性气道阻力（sRaw；n=80）和总气道阻力（Raw；n=84）也显著下降。在 T 期与 T 期的比较中，VC、FVC（n=67）、FEV（n=69）、TLC（n=67）明显增加，Raw（n=66）、sRaw、RV（n=65）和 RV/TLC（n=64）明显下降。在 T 期与 T 期的直接分析中，在取出杆后，VC（n=54）、FVC（n=52）和 TLC（n=55）明显增加，RV（n=51）和 RV/TLC 指数（n=50）明显下降，气道阻力参数如 Raw（n=52）和 sRaw（n=51）也明显下降。
MIRPE 完整手术后，患者的肺功能值和气道阻力标志物均有所改善。
2 级。
