Surgical treatment of 190 adults with pectus excavatum by newly modified orthopedic steel plate_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HU Fengqing , WANG Lei , WANG Mingsong , MEI Ju ,  LI Guoqing

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, P.R.China;

Corresponding author：

LI Guoqing, Email: liguoqing@xinhuamed.com.cn

Keywords：

Newly modified orthopedic steel plate; adult pectus excavatum; surgical treatment

DOI：

10.7507/1007-4848.201709006

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Objective To summarize the clinical experience of treating adults with pectus excavatum by newly modified orthopedicsteel plate and Nuss procedure. Methods The clinical data of 190 adults with pectus excavatum treated by newly modified Nuss procedure in Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2011 to June 2016 were collected. There were 151 males and 39 females aged 21.80±3.96 years ranging from 18 to 45 years. The therapeutic efficacy, Haller index and the lung function index were also analyzed. Results All patients recovered well after the operation. Two orthopedic steel plates were implanted in 12 patients. Pneumothorax was found in 7 patients postoperatively and 2 of them was treated by puncture extraction. There were 5 patients with poor healing of incision and all of them were healed after the debridement. Other complications such as steel plate shift was found in 2 patients. Both of them recovered after the reoperation. The duration of operation was 36–65 min. The intraoperative blood loss was 5–20 ml. Postoperative hospital stay was 4–7 days. Haller and lung function index improved after the operation (P<0.001). Conclusion It is effective and safe to treat the pectus excavatum by newly modified orthopedic steel plate and Nuss procedure in adult patients.

Citation： HU Fengqing, WANG Lei, WANG Mingsong, MEI Ju, LI Guoqing. Surgical treatment of 190 adults with pectus excavatum by newly modified orthopedic steel plate. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(8): 687-690. doi: 10.7507/1007-4848.201709006 Copy

1.	Jaroszewski DE, Ewais MM, Chao CJ, et al. Success of minimally invasive pectus excavatum procedures (modified Nuss) in adult patients (≥30 years). Ann Thorac Surg, 2016, 102(3): 993-1003.
2.	Erşen E, Demirkaya A, Kılıç B, et al. Minimally invasive repair of pectus excavatum (MIRPE) in adults: is it a proper choice? Wideochir Inne Tech Maloinwazyjne, 2016, 11(2): 98-104.
3.	Hoksch B, Kocher G, Vollmar P, et al. Nuss procedure for pectus excavatum in adults: long-term results in a prospective observational study. Eur J Cardiothorac Surg, 2016, 50(5): 934-939.
4.	Karakuş OZ, Ulusoy O, Hakgüder G, et al. Nuss procedure: Technical modifications to ease bending of the support bar and lateral stabilizer placement. Ann Thorac Med, 2016, 11(3): 214-218.
5.	Frawley G, Frawley J, Crameri J. A review of anesthetic techniques and outcomes following minimally invasive repair of pectus excavatum (Nuss procedure). Paediatr Anaesth, 2016, 26(11): 1082-1090.
6.	Li G, Jiang Z, Xiao H, et al. A novel modified Nuss procedure for pectus excavatum: a new steel bar. Ann Thorac Surg, 2015, 99(5): 1788-1792.
7.	McHugh MA, Poston PM, Rossi NO, et al. Assessment of potential confounders when imaging pectus excavatum with chest radiography alone. J Pediatr Surg, 2016, 51(9): 1485-1489.
8.	Ewais MM, Chaparala S, Uhl R, et al. Outcomes in adult pectus excavatum patients undergoing Nuss repair. Patient Relat Outcome Meas, 2018, 9: 65-90.
9.	Zuidema WP, Oosterhuis JWA, Zijp GW, et al. Early consequences of pectus excavatum surgery on self-esteem and general quality of life. World J Surg, 2018, [Epub ahead of print].
10.	Obermeyer RJ, Gaffar S, Kelly RE Jr., et al. Selective versus routine patch metal allergy testing to select bar material for the Nuss procedure in 932 patients over 10 years. J Pediatr Surg, 2018, 53(2): 260-264.
11.	Bond SJ, Rapstine E, Bond JM. Results of pectus excavatum correction using a minimally invasive approach with subxyphoid incision and three-point fixation. Pediatr Surg Int, 2018, 34(1): 75-78.
12.	Ashfaq A, Beamer S, Ewais MM, et al. Revision of failed prior Nuss in adult patients with pectus excavatum. Ann Thorac Surg, 2018, 105(2): 371-378.
13.	Chao CJ, Jaroszewski D, Gotway M, et al. Effects of pectus excavatum repair on right and left ventricular strain. Ann Thorac Surg, 2018, 105(1): 294-301.
14.	Sacco Casamassima MG, Gause C, Goldstein SD, et al. Patient satisfaction after minimally invasive repair of pectus excavatum in adults: long-term results of Nuss procedure in adults. Ann Thorac Surg, 2016, 101(4): 1338-1345.

1. Jaroszewski DE, Ewais MM, Chao CJ, et al. Success of minimally invasive pectus excavatum procedures (modified Nuss) in adult patients (≥30 years). Ann Thorac Surg, 2016, 102(3): 993-1003.
2. Erşen E, Demirkaya A, Kılıç B, et al. Minimally invasive repair of pectus excavatum (MIRPE) in adults: is it a proper choice? Wideochir Inne Tech Maloinwazyjne, 2016, 11(2): 98-104.
3. Hoksch B, Kocher G, Vollmar P, et al. Nuss procedure for pectus excavatum in adults: long-term results in a prospective observational study. Eur J Cardiothorac Surg, 2016, 50(5): 934-939.
4. Karakuş OZ, Ulusoy O, Hakgüder G, et al. Nuss procedure: Technical modifications to ease bending of the support bar and lateral stabilizer placement. Ann Thorac Med, 2016, 11(3): 214-218.
5. Frawley G, Frawley J, Crameri J. A review of anesthetic techniques and outcomes following minimally invasive repair of pectus excavatum (Nuss procedure). Paediatr Anaesth, 2016, 26(11): 1082-1090.
6. Li G, Jiang Z, Xiao H, et al. A novel modified Nuss procedure for pectus excavatum: a new steel bar. Ann Thorac Surg, 2015, 99(5): 1788-1792.
7. McHugh MA, Poston PM, Rossi NO, et al. Assessment of potential confounders when imaging pectus excavatum with chest radiography alone. J Pediatr Surg, 2016, 51(9): 1485-1489.
8. Ewais MM, Chaparala S, Uhl R, et al. Outcomes in adult pectus excavatum patients undergoing Nuss repair. Patient Relat Outcome Meas, 2018, 9: 65-90.
9. Zuidema WP, Oosterhuis JWA, Zijp GW, et al. Early consequences of pectus excavatum surgery on self-esteem and general quality of life. World J Surg, 2018, [Epub ahead of print].
10. Obermeyer RJ, Gaffar S, Kelly RE Jr., et al. Selective versus routine patch metal allergy testing to select bar material for the Nuss procedure in 932 patients over 10 years. J Pediatr Surg, 2018, 53(2): 260-264.
11. Bond SJ, Rapstine E, Bond JM. Results of pectus excavatum correction using a minimally invasive approach with subxyphoid incision and three-point fixation. Pediatr Surg Int, 2018, 34(1): 75-78.
12. Ashfaq A, Beamer S, Ewais MM, et al. Revision of failed prior Nuss in adult patients with pectus excavatum. Ann Thorac Surg, 2018, 105(2): 371-378.
13. Chao CJ, Jaroszewski D, Gotway M, et al. Effects of pectus excavatum repair on right and left ventricular strain. Ann Thorac Surg, 2018, 105(1): 294-301.
14. Sacco Casamassima MG, Gause C, Goldstein SD, et al. Patient satisfaction after minimally invasive repair of pectus excavatum in adults: long-term results of Nuss procedure in adults. Ann Thorac Surg, 2016, 101(4): 1338-1345.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical treatment of 190 adults with pectus excavatum by newly modified orthopedic steel plate

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