Thoracic Surgery Department, University and Hospital Trust-Ospedale Borgo Trento, Verona, Italy.
Thoracic Surgery Department, Humanitas Research Hospital, Rozzano (Milano), Italy.
Asian Cardiovasc Thorac Ann. 2024 Sep;32(6-7):409-416. doi: 10.1177/02184923241272887. Epub 2024 Aug 12.
The Nuss procedure is the primary treatment for pectus excavatum (PE), but patient expectations are not always met. In our unit, our standard approach in the last few years has been the routine application of two bars instead of one. We aimed to retrospectively assess the impact of this approach on patient satisfaction, quality of life (QoL) and safety.
A retrospective study included 182 patients over 16 years old who underwent the Nuss procedure for PE between January 2007 and September 2021. Patients were categorized into one-bar or two-bar correction groups. Propensity score matching (PSM) was used, resulting in 30 patients in each group. Primary endpoints were QoL and cosmetic satisfaction, while secondary endpoints included complications and recurrence.
After PSM, both groups showed similar general characteristics. Patients treated with two bars reported fewer psychological complaints post-surgery (93.3% vs. 73.3%, = 0.031). There were no significant differences in QoL improvement (96.7% in both groups, = 0.197), perioperative complications ( = 0.771) or recurrence (one patient in the one-bar group, = 1.000).
Our study reveals that patients undergoing the Nuss Procedure for PE with two bars exhibit comparable clinical outcomes and QoL to those with one bar. However, patients with two bars may have higher levels of psychological well-being and satisfaction, indicating potential benefits associated with this approach. These findings suggest potential advantages of the two-bar approach, but further research with larger sample sizes is warranted to confirm these observations.
Nuss 手术是治疗漏斗胸（PE）的主要方法，但患者的期望并不总是得到满足。在我们科室，过去几年我们的标准方法是常规应用两条而不是一条矫正杆。我们旨在回顾性评估这种方法对患者满意度、生活质量（QoL）和安全性的影响。
一项回顾性研究纳入了 2007 年 1 月至 2021 年 9 月期间因 PE 接受 Nuss 手术的 182 名 16 岁以上的患者。患者分为单杠或双杠矫正组。采用倾向评分匹配（PSM），每组匹配 30 例患者。主要终点为 QoL 和美容满意度，次要终点包括并发症和复发。
PSM 后，两组的一般特征相似。双杠治疗的患者术后心理投诉较少（93.3%比 73.3%， = 0.031）。两组 QoL 改善无显著差异（均为 96.7%， = 0.197），围手术期并发症（ = 0.771）或复发（单杠组 1 例， = 1.000）也无显著差异。
我们的研究表明，PE 患者接受 Nuss 手术应用双杠与单杠相比具有相似的临床结果和 QoL。然而，双杠组患者的心理健康和满意度可能更高，表明这种方法可能具有潜在的优势。这些发现表明双杠方法具有潜在的优势，但需要更大样本量的进一步研究来证实这些观察结果。
