Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego St. 62, Poznań, 60-569, Poland.
Greater Poland Center of Digital Medicine, Poznan University of Medical Sciences, Rokietnicka 7, Street, Poznań, 60-806, Poland.
Sci Rep. 2024 Nov 16;14(1):28285. doi: 10.1038/s41598-024-79562-1.
The Nuss procedure is the most common corrective surgery for pectus excavatum. We analyzed treatment outcomes and complication rates in 1238 patients treated with the Nuss procedure from 2002 to 2021, focusing on the number of corrective bars used. Using Propensity Score Matching based on age, sex, BMI, pre-operative FEV1, and the Haller index, we created two groups: 546 patients with a single bar and 546 with two bars. Both groups achieved similar correction effects (Haller index: single bar = 2.58 vs. two bars = 2.56; p = 0.65). In the univariate analysis, in the two-bar group, the postoperative complications were observed more often (28.6% vs. 15.4%, p < 0.001), including pneumothorax (11.2% vs. 6.2%, p < 0.001), hemothorax (3.7% vs. 0.7%, p < 0.001), additional drainage (13.7% vs. 5.3%, p < 0.001), the need for thoracentesis (8.6% vs. 2.9%, p < 0.001), bar displacement (3.8% vs. 0.7%, p < 0.001), pleural effusion (10.6% vs. 3.1%, p < 0.001), and fever (6.6% vs. 3.8%, p < 0.041). In the logistic regression, two bars significantly increased the risk of postoperative complications (p = 0.019), including hematoma (p = 0.036), pleural effusion (p = 0.002), and the need for thoracentesis (p = 0.013). Using two corrective bars during the Nuss procedure is associated with a higher rate of postoperative complications but similar corrective results.
Nuss 手术是治疗漏斗胸最常见的矫正手术。我们分析了 2002 年至 2021 年间 1238 例接受 Nuss 手术治疗的患者的治疗结果和并发症发生率，重点关注使用的矫正棒数量。我们使用基于年龄、性别、BMI、术前 FEV1 和 Haller 指数的倾向评分匹配，创建了两组：546 例使用单根矫正棒和 546 例使用双根矫正棒。两组均获得了相似的矫正效果（Haller 指数：单根矫正棒=2.58 vs. 双根矫正棒=2.56；p=0.65）。在单因素分析中，双根矫正棒组术后并发症更常见（28.6% vs. 15.4%，p<0.001），包括气胸（11.2% vs. 6.2%，p<0.001）、血胸（3.7% vs. 0.7%，p<0.001）、需要额外引流（13.7% vs. 5.3%，p<0.001）、需要胸腔穿刺（8.6% vs. 2.9%，p<0.001）、矫正棒移位（3.8% vs. 0.7%，p<0.001）、胸腔积液（10.6% vs. 3.1%，p<0.001）和发热（6.6% vs. 3.8%，p<0.041）。在逻辑回归中，双根矫正棒显著增加了术后并发症的风险（p=0.019），包括血肿（p=0.036）、胸腔积液（p=0.002）和需要胸腔穿刺（p=0.013）。在 Nuss 手术中使用两根矫正棒会增加术后并发症的发生率，但矫正效果相似。
