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青少年微创鸡胸矫正的个体化治疗:单中心回顾性研究。

The individualized treatment for minimally invasive repair of pectus carinatum in adolescent: a single center' s retrospective study.

机构信息

Cardiothoracic surgery department, children' s hospital of Soochow university, No. 92 Zhongnan Street, Suzhou, 215000, Jiangsu Province, China.

出版信息

J Cardiothorac Surg. 2024 Aug 16;19(1):483. doi: 10.1186/s13019-024-02910-9.

DOI:10.1186/s13019-024-02910-9
PMID:39148133
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11328510/
Abstract

BACKGROUND

Pectus carinatum (PC) mainly present at the growth spurt time of the early teenage years or the puberty. Poor outer appearance is a major reason for seeking help for surgeons to increase self-confidence and self-esteem. At present, minimally invasive repair (MIR) is one of effective ways to correct the chest wall deformity. Therefore, there is great practical significance to conduct clinical research on MIR about the adolescent PC.

METHODS

We applied Abramson procedure in PC group or we applied Abramson procedure and Nuss procedure in PC/PE group. We retrospectively reviewed the results of 41 cases who underwent the surgical correction at our department from January 2020 to April 2023.

RESULTS

All the procedures were successfully done without severe complications. The median operation Time was 80 min in PC group while was 130 min in PC/PE group. The median LOS were 4 days in PC group while 5 days in PC/PE group. The median compression depth was 32 mm in PC group while 12 mm in PC/PE group. Postoperatively, there are some complications. All Pneumothorax patients being treated conservatively were found in 9 patients in two groups. One patient suffered overcorrection after operation. There were 3 patients suffered steel wires breakage in two groups. One patient reoperation postoperatively for the dislocation of the bar secondary to steel wires breakage.

CONCLUSIONS

The Abramson procedure or Abramson procedure and Nuss procedure have good short-term results in repair PC and PC/PE. Select one or two procedures should be done individually based on whether the lower plane over depressed after Abramson procedure.

摘要

背景

鸡胸(pectus carinatum,PC)主要发生在青少年生长突增期或青春期。外观不佳是寻求外科医生帮助的主要原因,目的是增加自信和自尊心。目前,微创修复(minimally invasive repair,MIR)是矫正胸壁畸形的有效方法之一。因此,对青少年 PC 进行 MIR 的临床研究具有重要的现实意义。

方法

我们在 PC 组应用 Abramson 手术,在 PC/PE 组应用 Abramson 手术联合 Nuss 手术。我们回顾性分析了 2020 年 1 月至 2023 年 4 月在我科接受手术矫正的 41 例患者的结果。

结果

所有手术均顺利完成,无严重并发症。PC 组的中位手术时间为 80 分钟,PC/PE 组为 130 分钟。PC 组的中位住院时间为 4 天,PC/PE 组为 5 天。PC 组的中位压缩深度为 32 毫米,PC/PE 组为 12 毫米。术后出现一些并发症。两组均有 9 例气胸患者经保守治疗发现。1 例术后发生过度矫正。两组均有 3 例钢丝断裂。1 例因钢丝断裂致棒脱位而行二次手术。

结论

Abramson 手术或 Abramson 手术联合 Nuss 手术在修复 PC 和 PC/PE 方面具有良好的短期效果。应根据 Abramson 手术后下平面是否凹陷来选择单独进行一种或两种手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/6873d63ea8d6/13019_2024_2910_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/54884450dd90/13019_2024_2910_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/f391f3ccf718/13019_2024_2910_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/761eb597af4e/13019_2024_2910_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/cfacf6f8f5f5/13019_2024_2910_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/6873d63ea8d6/13019_2024_2910_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/54884450dd90/13019_2024_2910_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/f391f3ccf718/13019_2024_2910_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/761eb597af4e/13019_2024_2910_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/cfacf6f8f5f5/13019_2024_2910_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8123/11328510/6873d63ea8d6/13019_2024_2910_Fig5_HTML.jpg

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