Impact of Nuss procedure on chest wall

Abstract

Objective To introduce a new measurement that can be used to evaluate the improvement of the chest wall after Nuss procedure.Methods From April 2004 to March 2008,449 pectus excavatum(PE) patients received Nuss procedure in Hospital,and according to the inclusion criteria,there were 80 cases enrolled our group at last,then divided the cases into two groups,one group of pre-operative of Nuss surgery,and the other group of post-bar removal.All the cases had examination of posterio-anterior chest radiographs before Nuss procedure and after Nuss bar removal.The maximal distance of the outer boundary of each rib pairs (C,from the 1 st pair to the 9th),the distance between lung apex to the costophrenic angle(H)and the distance between the two costophrenic angles (W),were measured.Results All the 80 cases completed the Nuss procedure and Nuss bar removal safely and effectively.All the patients were followed up from 30 to 36 months,and no recurrence or long-term complications occurred.The measured values of post-bar removal group showed significantly increased compare to the group of pre-Nuss procedure.The measured values (rib of 5 th,6th,7th) of post-bar removal group showed statistically significant compare to the group of normal children of the same age group.Conclusion The chest wall of post-bar removal was significantly increased compare to the cases of pre-Nuss procedure.Compare to the group of normal children of the same age group,there may be some restrictions on the thoracic by the pectus bar in the group of pectus,but whether there are still thorax limited,we need further more follow-up and measurement of chest X-ray to clear. Key words: Pectus excavatum ; Nuss procedure ; Chest wall