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接受微创矫正的漏斗胸畸形患者的术后拔管结果

Post bar removal results of pectus deformity patients who underwent minimally invasive correction.

作者信息

Kılıç Burcu, Saglam Omer Faruk, Guler Gokberk, Ersen Ezel, Kara Hasan Volkan, Demirkaya Ahmet, Turna Akif, Kaynak Kamil

机构信息

Department of Thoracic Surgery, Faculty of Medicine, Istanbul University Cerrahpasa, Cerrahpasa, Turkey.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2023 Jun;18(2):364-371. doi: 10.5114/wiitm.2022.123797. Epub 2023 Jan 2.

Abstract

INTRODUCTION

The most common chest wall deformities are pectus excavatum and pectus carinatum. Surgical repair of these deformities via minimally invasive technique using pectus bars is commonly preferred by numerous thoracic surgeons. Despite this common choice for treatment, the duration of the bar stay, the bar removal process, the possible complications and ways to prevent them have been debated over the years and still there is no single decision.

AIM

To determine the decision making, surgical outcomes and negative factors in the bar removal process.

MATERIAL AND METHODS

There were 1032 patients underwent bar removal between 2006-2020 and their data was recorded prospectively. We analyzed patients' demographics, family history, Haller index, bar count, body mass index, stabilizer and wire usage, length of hospital stay, time until bar removal, incision side and complications retrospectively.

RESULTS

There was no significant correlation between BMI and surgery time (p = 0.748). There was no statistically significant correlation between the age groups and the number of pectus bars removed. The other factors showed no significant difference. The surgery time was found to be significantly longer in those with callus tissue (p = 0.002).

CONCLUSIONS

These findings suggest that pectus bars can be left in place for a shorter time than the standard 3-year interval without any additional recurrence risk and without compromising quality of life. As a result, patients with persistent pain after pectus repair should be well evaluated for the possibility of life-threatening complications during bar removal.

摘要

引言

最常见的胸壁畸形是漏斗胸和鸡胸。许多胸外科医生通常更倾向于采用微创技术使用胸壁矫形钢板对这些畸形进行手术修复。尽管这种治疗选择很常见,但多年来关于钢板留置时间、钢板取出过程、可能的并发症以及预防方法一直存在争议,且尚无统一的定论。

目的

确定钢板取出过程中的决策制定、手术结果及负面因素。

材料与方法

2006年至2020年间有1032例患者接受了钢板取出手术,其数据进行了前瞻性记录。我们回顾性分析了患者的人口统计学资料、家族史、哈勒指数、钢板数量、体重指数、稳定器和钢丝的使用情况、住院时间、钢板取出前的时间、切口侧别及并发症。

结果

体重指数与手术时间之间无显著相关性(p = 0.748)。各年龄组与取出的胸壁矫形钢板数量之间无统计学显著相关性。其他因素无显著差异。发现有骨痂组织的患者手术时间明显更长(p = 0.002)。

结论

这些发现表明,胸壁矫形钢板的留置时间可以比标准的3年间隔更短,而不会增加额外的复发风险,也不会影响生活质量。因此,对于鸡胸修复术后持续疼痛的患者,应充分评估钢板取出过程中出现危及生命并发症的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e96d/10481444/41a25c751073/WIITM-18-49783-g001.jpg

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