Pectus Excavatum Surgery: Sternochondroplasty Versus Nuss Procedure
| Autor: | Lucas de Matos Fernandes, Ruy Fernando Kuenzer Caetano Silva, Marlos de Souza Coelho, Nelson Bergonse Neto, Anna Flávia Ribeiro dos Santos, Rafael Garbelotto Mendes, Wilson de Souza Stori |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Nuss procedure Young Adult Pectus excavatum medicine Humans Complication rate Child business.industry Plastic Surgery Procedures medicine.disease Sternotomy Transverse incision Surgery Cartilage Treatment Outcome Patient Satisfaction Funnel Chest Anesthesia Pectus carinatum Female Congenital disease Cardiology and Cardiovascular Medicine business Hospital stay |
| Zdroj: | The Annals of Thoracic Surgery. 88:1773-1779 |
| ISSN: | 0003-4975 |
| Popis: | Background The repair of pectus excavatum (PE) by minimally invasive Nuss surgery is well established, but its complication rate is high and its indication is indiscriminate. Sternochondroplasty (SCP) provides good results with a low complication rate but requires a small transverse incision. Methods To compare SCP and Nuss, we analyzed 40 patients with PE who underwent surgery (SCP, n=20; Nuss, n=20). Thirty subjects (75.0%) were male and 10 (25.0%) were female. In the SCP group, 9 (45.0%) had symmetric PE, and 11 (55.0%) had asymmetric PE. In the Nuss group, 17 (85%) had symmetric PE, and 3 (15%) had asymmetric PE ( p = 0.020). Results The mean duration of SCP was 229.5 minutes, and the mean duration of Nuss was 54.3 minutes. The average length of hospital stay was 4 days with SCP and 6.3 days with Nuss ( p = 0.172). The SCP results were favorable in 18 subjects (90%) and fair in 2 subjects (10%). In the Nuss group, we observed 17 patients (85.0%) with favorable results and 3 (15.0%) with poor results. Patients with asymmetric PE exhibited severe pectus carinatum. No complications were found in 17 patients (85%) in the SCP group. In the Nuss group, 9 patients (45.0%) had 13 complications (65.0%; p = 0.004). Conclusions Sternochondroplasty surgery yielded better results than the Nuss procedure and more patients with asymmetric PE, less pain, and fewer complications. Nuss surgery had shorter operating times than SCP, younger patients, more symmetric PE, and 3 patients who experienced severe postoperative asymmetric pectus carinatum. In summary, for asymmetric PE the best indication is SCP. |
| Databáze: | OpenAIRE |
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