Sheldon J Bond1, Emily Rapstine2, Jordan M Bond2. 1. Department of Surgery, Division of Pediatric Surgery, University of Louisville, 315 E. Broadway, Ste 565, Louisville, KY, 40202, USA. sjbond01@louisville.edu. 2. Department of Surgery, University of Louisville, Louisville, KY, USA.
Abstract
OBJECTIVES: This study reviews the results of our previously described modification of the minimally invasive (Nuss) procedure for correction of pectus excavatum. It utilizes a subxyphoid incision with central fixation to maximize safe bar passage and minimize bar displacement. METHODS: Consecutive patients corrected with the modified Nuss procedure between 2010 and 2015 form the basis of this study. RESULTS: During the study period, 73 patients had correction of their pectus excavatum by the modified Nuss procedure, utilizing subxyphoid incision and central fixation. Average age was 14.3 (range 8-19). 54 patients were male, 19 female. The average Haller index was 4.3 (range 3.2-7.2). No episodes of cardiac perforation, hemothorax or significant pneumothorax were recorded. Bar displacement occurred in two patients (2.7%) with one late recurrence after bar removal. CONCLUSIONS: Our modification of the Nuss procedure is effective at preventing intrathoracic complications and cardiac perforation. Central fixation had a lower rate of bar displacement compared to published reports. Additional efforts are needed to further reduce bar displacement.
OBJECTIVES: This study reviews the results of our previously described modification of the minimally invasive (Nuss) procedure for correction of pectus excavatum. It utilizes a subxyphoid incision with central fixation to maximize safe bar passage and minimize bar displacement. METHODS: Consecutive patients corrected with the modified Nuss procedure between 2010 and 2015 form the basis of this study. RESULTS: During the study period, 73 patients had correction of their pectus excavatum by the modified Nuss procedure, utilizing subxyphoid incision and central fixation. Average age was 14.3 (range 8-19). 54 patients were male, 19 female. The average Haller index was 4.3 (range 3.2-7.2). No episodes of cardiac perforation, hemothorax or significant pneumothorax were recorded. Bar displacement occurred in two patients (2.7%) with one late recurrence after bar removal. CONCLUSIONS: Our modification of the Nuss procedure is effective at preventing intrathoracic complications and cardiac perforation. Central fixation had a lower rate of bar displacement compared to published reports. Additional efforts are needed to further reduce bar displacement.
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Authors: Mindy W C Lam; Anne F Klassen; Carolyne J Montgomery; Jacques G LeBlanc; Erik D Skarsgard Journal: J Pediatr Surg Date: 2008-05 Impact factor: 2.545
Authors: Robert E Kelly; Robert B Mellins; Robert C Shamberger; Karen K Mitchell; M Louise Lawson; Keith T Oldham; Richard G Azizkhan; Andre V Hebra; Donald Nuss; Michael J Goretsky; Ronald J Sharp; George W Holcomb; Walton K T Shim; Stephen M Megison; R Lawrence Moss; Annie H Fecteau; Paul M Colombani; Dan Cooper; Traci Bagley; Amy Quinn; Alan B Moskowitz; James F Paulson Journal: J Am Coll Surg Date: 2013-12 Impact factor: 6.113
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