Efficacy of novel modified Nuss procedure in treatment of pectus excavatum after congenital heart disease operation: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Lei , HU Fengqing , HU Rui , MENG Lifei , WANG Mingsong , XIAO Haibo ,  LI Guoqing , MEI Ju

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, P.R.China;

Corresponding author：

LI Guoqing, Email: liguoqing@xinhuamed.com.cn

Keywords：

Novel modified Nuss procedure; congenital heart disease; pectus excavatum

DOI：

10.7507/1007-4848.201705004

Video：

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Objective To explore the feasibility and efficacy in therapy of pectus excavatum using novel modified Nuss procedure after congenital heart disease (CHD) operation. Methods Thirty-six children (including 22 males and 14 females with an average age of 4.5±2.2 years ranging 2.8-18.0 years) with pectus excavatum after CHD operation from January 2011 to March 2015 were selected as an observation group. Thirty-eight pectus excavatum children (including 24 males and 14 females with an average age of 4.0±2.5 years ranging 2.8-20.0 years) without CHD from July to September 2013 were selected as a control group. The novel modified Nuss procedure was performed on the patients in both groups. The operation time, intraoperative blood loss, hospital stay as well as postoperative complications between two groups were reviewed and analyzed. Results In the observation group, the operation time was 50-72 (60.50±3.60) min and hospital stay was 4-6 (4.41±0.80) d. Meanwhile, the intraoperative blood loss was 5-10 (5.82±0.35) ml. In the control group, the operation time was 12-45 (20.15±0.68) min, hospital stay was 4-7 (4.61±0.63) d and the intraoperative blood loss was 3-8 (4.62±0.28) ml. The operation time was significantly longer in the observation group than that in the control group (P<0.05). But there was no significant difference in intraoperative blood loss or hospital stay between the two groups (P>0.05). No cardiac rupture happened in the two groups. Conclusion The novel modified Nuss procedure is safe and feasible for pectus excavatum after CHD operation with optimal outcomes.

Citation： WANG Lei, HU Fengqing, HU Rui, MENG Lifei, WANG Mingsong, XIAO Haibo, LI Guoqing, MEI Ju. Efficacy of novel modified Nuss procedure in treatment of pectus excavatum after congenital heart disease operation: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(3): 213-217. doi: 10.7507/1007-4848.201705004 Copy

1.	Li S, Tang ST, Tong Q, et al. Nuss repair of pectus excavatum after surgery for congenital heart disease: experience from a single institution. J Thorac Cardiovasc Surg, 2014, 148(2): 657-661.
2.	Abid I, Ewais MM, Marranca J, et al. Pectus Excavatum: A Review of Diagnosis and Current Treatment Options. J Am Osteopath Assoc, 2017, 117(2): 106-113.
3.	Pilegaard H, Licht PB. Minimal Invasive Repair of Pectus Excavatum and Carinatum. Thorac Surg Clin, 2017, 27(2): 123-131.
4.	Graves CE, Hirose S, Raff GW, et al. Magnetic Mini-Mover Procedure for pectus excavatum IV: FDA sponsored multicenter trial. J Pediatr Surg, 2017, 52(6): 913-919.
5.	Roubertie F, Ramanan S, Lavrand F, et al. Combined Nuss Procedure and Cardiac Procedure Through a Left Anterolateral Thoracotomy. Ann Thorac Surg, 2016, 102(6): e537-e539.
6.	Haecker FM, Sesia S. Vacuum bell therapy. Ann Cardiothorac Surg, 2016, 5(5): 440-449.
7.	Schmidt J, Redwan B, Koesek V, et al. Pectus excavatum and cardiac surgery: simultaneous correction advocated. Thorac Cardiovasc Surg, 2014, 62(3): 238-244.
8.	Ahn J, Choi JI, Shim J, et al. Right Ventricular Compression Mimicking Brugada-Like Electrocardiogram in a Patient with Recurrent Pectus Excavatum. Case Rep Cardiol, 2017, 2017: 3047937.
9.	Sun Y, Zhu P, Zheng SY. Simultaneous repair of pectus excavatum and congenital heart disease without cardiopulmonary bypass or sternal osteotomy. J Cardiothorac Surg, 2014, 9: 168.
10.	石卓, 徐玮泽, 李建华, 等. 与先天性心脏病相关的 NUSS 术. 中华小儿外科杂志, 2011, 32(4): 278-281.
11.	曾骐, 彭芸, 贺延儒, 等. Nuss 手术治疗小儿漏斗胸(附 60 例报告). 中华胸心血管外科杂志, 2004, 20(4): 223-225.
12.	An HS, Choi EY, Kwon BS, et al. Airway compression in children with congenital heart disease evaluated using computed tomography. Ann Thorac Surg, 2013, 96(6): 2192-2197.
13.	Li S, Yang D, Ma Y, et al. Hybrid Nuss Procedure for Pectus Excavatum With Severe Retrosternal Adhesions After Sternotomy. Ann Thorac Surg, 2017, 103(5): 1573-1577.
14.	Li G, Jiang Z, Xiao H, et al. A novel modified Nuss procedure for pectus excavatum: a new steel bar. Ann Thorac Surg, 2015, 99(5): 1788-1792.
15.	李帅, 汤绍涛, 余鋮, 等. 先天性心脏病术后漏斗胸行 Nuss 手术 28 例. 中华小儿外科杂志, 2012, 33(12): 890-893.
16.	Liodakis E, Liodaki E, Basmajian HG, et al. Pectus excavatum in blunt chest trauma: a case report. J Med Case Rep, 2013, 7: 22.
17.	Oncel M, Sunam GS, Yildiran H. Surgical Repair of Pectus Excavatum. Ann Thorac Surg, 2016, 102(5): 1763-1764.

1. Li S, Tang ST, Tong Q, et al. Nuss repair of pectus excavatum after surgery for congenital heart disease: experience from a single institution. J Thorac Cardiovasc Surg, 2014, 148(2): 657-661.
2. Abid I, Ewais MM, Marranca J, et al. Pectus Excavatum: A Review of Diagnosis and Current Treatment Options. J Am Osteopath Assoc, 2017, 117(2): 106-113.
3. Pilegaard H, Licht PB. Minimal Invasive Repair of Pectus Excavatum and Carinatum. Thorac Surg Clin, 2017, 27(2): 123-131.
4. Graves CE, Hirose S, Raff GW, et al. Magnetic Mini-Mover Procedure for pectus excavatum IV: FDA sponsored multicenter trial. J Pediatr Surg, 2017, 52(6): 913-919.
5. Roubertie F, Ramanan S, Lavrand F, et al. Combined Nuss Procedure and Cardiac Procedure Through a Left Anterolateral Thoracotomy. Ann Thorac Surg, 2016, 102(6): e537-e539.
6. Haecker FM, Sesia S. Vacuum bell therapy. Ann Cardiothorac Surg, 2016, 5(5): 440-449.
7. Schmidt J, Redwan B, Koesek V, et al. Pectus excavatum and cardiac surgery: simultaneous correction advocated. Thorac Cardiovasc Surg, 2014, 62(3): 238-244.
8. Ahn J, Choi JI, Shim J, et al. Right Ventricular Compression Mimicking Brugada-Like Electrocardiogram in a Patient with Recurrent Pectus Excavatum. Case Rep Cardiol, 2017, 2017: 3047937.
9. Sun Y, Zhu P, Zheng SY. Simultaneous repair of pectus excavatum and congenital heart disease without cardiopulmonary bypass or sternal osteotomy. J Cardiothorac Surg, 2014, 9: 168.
10. 石卓, 徐玮泽, 李建华, 等. 与先天性心脏病相关的 NUSS 术. 中华小儿外科杂志, 2011, 32(4): 278-281.
11. 曾骐, 彭芸, 贺延儒, 等. Nuss 手术治疗小儿漏斗胸(附 60 例报告). 中华胸心血管外科杂志, 2004, 20(4): 223-225.
12. An HS, Choi EY, Kwon BS, et al. Airway compression in children with congenital heart disease evaluated using computed tomography. Ann Thorac Surg, 2013, 96(6): 2192-2197.
13. Li S, Yang D, Ma Y, et al. Hybrid Nuss Procedure for Pectus Excavatum With Severe Retrosternal Adhesions After Sternotomy. Ann Thorac Surg, 2017, 103(5): 1573-1577.
14. Li G, Jiang Z, Xiao H, et al. A novel modified Nuss procedure for pectus excavatum: a new steel bar. Ann Thorac Surg, 2015, 99(5): 1788-1792.
15. 李帅, 汤绍涛, 余鋮, 等. 先天性心脏病术后漏斗胸行 Nuss 手术 28 例. 中华小儿外科杂志, 2012, 33(12): 890-893.
16. Liodakis E, Liodaki E, Basmajian HG, et al. Pectus excavatum in blunt chest trauma: a case report. J Med Case Rep, 2013, 7: 22.
17. Oncel M, Sunam GS, Yildiran H. Surgical Repair of Pectus Excavatum. Ann Thorac Surg, 2016, 102(5): 1763-1764.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of novel modified Nuss procedure in treatment of pectus excavatum after congenital heart disease operation: A case control study

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