A hybrid approach to maximize safety with thoracoscopic Nuss procedure after prior sternotomy

Autor: Krista Lai, Dawn E. Jaroszewski, Lisa E. McMahon
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Pediatric Surgery Case Reports, Vol 81, Iss , Pp 102278- (2022)
Druh dokumentu: article
ISSN: 2213-5766
DOI: 10.1016/j.epsc.2022.102278
Popis: The Nuss procedure for pectus excavatum repair in patients with history of sternotomies is technically challenging with the potential for serious complications including cardiac injury, which has been reported in 7% of cases. A pre-emptive redo sternotomy to free the mediastinum of adhesions and permit safe, unobstructed bar passage may mitigate this risk. Forced sternal elevation with sternal wires and the Rultract retractor creates additional space to achieve this. We advocate that this hybrid approach be standard of care to minimize intraoperative risks for this cohort of patients.
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