Abstract
BackgroundShortcoming of traditional Nuss operation on adults is gradually found in the clinical practice. A new kind of introducer-bar complex was introduced. However, there is limited evidence regarding its safety and efficacy. Therefore, a single center, retrospective study was conducted to address this issue.MethodsPatients with pectus excavatum who underwent surgery between January 2015 and June 2017 were consecutively enrolled in this study. In all, 52 patients underwent the modified procedure using the introducer-bar complex (new procedure group), whereas 48 underwent the traditional anti-Nuss procedure (traditional procedure group). Outcomes analysis of balanced baseline was performed to compare the intraoperative and postoperative short-term outcomes.ResultsAll patients in the new procedure group had shorter operation duration (51.54 ± 20.32 vs. 79.45 ± 13.88 min, p = 0.017), postoperative hospitalizations (4.77 ± 1.62 vs. 6.86 ± 2.18 days, p = 0.028), plate removal surgery durations (39.30 ± 8.97 vs. 60.30 ± 10.49 min, p < 0.001), and less blood loss during operation (6.25 ± 4.88 vs. 10.90 ± 5.75 ml, p = 0.003) than patients in the traditional procedure group. There was no significant difference in the length of incision, postoperative Haller index, cost, number of steel bars, postoperative surgical outcome and incidence of complications between the two groups.ConclusionThrough the main clinical outcome were similar, our results shown that modified procedure may have the shorter operation time, postoperative hospital stay, and operation time for plate removal and less blood loss, which may bring potential clinical benefits to patients.
Highlights
Pectus excavatum (PE) is the most common congenital deformity of the anterior wall of the chest, affecting 1–8 per 1000 live births
Patient groups This is a single center clinical cohort study based on retrospective analysis of prospectively collected data on patients with pectus excavatum who underwent surgical correction from January 2015 to June 2017, total 100 patients were identified from databases. 52 cases received modified Nuss procedure using introducer-bar complex as the new procedure group, while 48 cases received traditional Nuss procedure as the traditional procedure group
We evaluated the outcomes as follows: sternum depression evaluated by Chest CT scan, the symmetry of the chest wall morphology, depression and the satisfactions of patient and their families: the thorax appears full with good extension and elasticity
Summary
Pectus excavatum (PE) is the most common congenital deformity of the anterior wall of the chest, affecting 1–8 per 1000 live births. Wang et al J Cardiothorac Surg (2021) 16:267 was required to be shaped with special tools before the operation leading to the increase of operation time. It was difficult and traumatic when turning over the steel bar in the traditional Nuss procedure. To address the above shortcomings, we designed a new kind of introducer-bar complex [8]. The introducer-bar complex could be installed or removed by being pushed in or pulled out through the tunnel without being turned over widely, which was easier and less invasive than in traditional Nuss procedure. A new kind of introducer-bar complex was introduced.
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