Minimally Invasive Repair of Pectus Excavatum - The Nuss Procedure. A European Multicentre Experience

Hosie, S.; Sitkiewicz, Tomasz; Petersen, Claus; Göbel, P; Schaarschmidt, K.; Till, Holger; Noatnick, M.; Winiker, H.; Hagl, Christian; Schmedding, Andrea; Waag, Karl-Ludwig

doi:10.1055/s-2002-34486

Cited by 105 publications

(75 citation statements)

References 4 publications

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“…Several papers have been published on the results of this technique. Most series are small in numbers but some centres have extensive experience [2,13,20,21] and reports are emerging where the technique has been used in adults [6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Can absorbable stabilizers be used routinely in the Nuss procedure?☆

Pilegaard

Licht

2009

European Journal of Cardio-Thoracic Surgery

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Objective: During minimal invasive surgical correction of pectus excavatum the metal bar is rotated 1808 and fixed by one or two stabilisers. Previously, all stabilisers were made from metal, but they often caused chronic pain and had to be removed. Recently, a slowly absorbable stabiliser made from Lactosorb W has been introduced. Methods: From 2001 to 2008 a total of 507 patients underwent minimally invasive repair of pectus excavatum at Aarhus University Hospital. Since February 2007 we routinely used absorbable stabilisers made by Lactosorb W . We always used shorter pectus bars than originally suggested and always placed one stabiliser close to the entry in the thoracic cavity on the left side. All operations were performed by the same surgeon and all patients were seen 6 weeks after surgery. Patient records were reviewed for retrospective analysis. Results: In 422 patients we used a metal stabiliser while 85 patients received a Lactosorb W stabilizer. Seven patients received two stabilisers. During the follow-up period one metal stabiliser broke after 2(1/2) years (0.2%), but within 6 weeks after surgery three Lactosorb W stabilizers broke (3.5%) and another three dislocated laterally (3.5%). Conclusions: Absorbable stabilisers may be used for minimal invasive surgery for pectus excavatum but they are more vulnerable and break easier than metal stabilisers. This is likely a consequence of high stress forces that may be more pronounced in patients who receive a shorter pectus bar, but further research is needed. #

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Section: Discussionmentioning

confidence: 99%

Can absorbable stabilizers be used routinely in the Nuss procedure?☆

Pilegaard

Licht

2009

European Journal of Cardio-Thoracic Surgery

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“…In 1998, a new technique of minimally invasive repair of PE (MIRPE) was first described by Nuss [3] to avoid several operative features of the modified Ravitch repair procedure. Today, the MIRPE technique is well established and represents a common used technique [4][5][6][7][8][9]. The shorter operating time, smaller incisions, and considerably less dissection have made the MIRPE procedure very appealing both to surgeons and patients, thereby resulting in a large increase of the number of patients requesting operative treatment, and consequently, an increase of the number of PE repairs.…”

Section: Introductionmentioning

confidence: 99%

The vacuum bell for conservative treatment of pectus excavatum: the Basle experience

Haecker

2011

Pediatr Surg Int

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Objective Surgical repair of pectus excavatum (PE) in childhood is a well-established procedure. Previously used operative techniques to correct PE were largely based on the Ravitch technique. Since about 10 years, the minimally invasive repair (MIRPE) by Nuss is well established. Conservative treatment with the vacuum bell to elevate the funnel in patients with PE represents a potential alternative to surgery in selected patients. Methods A suction cup is used to create a vacuum at the anterior chest wall. Three different sizes of vacuum bell exist which are selected according to the individual patients age. When creating the vacuum, the lift of the sternum is obvious and remains for a different time period. The device should be used for a minimum of 30 min (twice/day), and may be used up to a maximum of several hours daily. Results One hundred and thirty-three patients (110 males, 23 females) aged from 3 to 61 years (median 16.21 years) used the vacuum bell for 1 to a maximum of 36 months. Computed tomographic scans showed that the device lifted the sternum and ribs immediately. In addition, this was confirmed thoracoscopically during the MIRPE procedure. One hundred and five patients showed a permanent lift of the sternum for more than 1 cm after 3 months of daily application. Thirteen patients stopped the application and underwent MIRPE. Relevant side effects were not noted. Conclusion The vacuum bell has proved to be an alternative therapeutic option in selected patients suffering from PE. The initial results proved to be dramatic, but long-term results are so far lacking, and further evaluation and follow-up studies are necessary.

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“…Characteristic feature of FCHD is tendency to progression, which is closely linked with a growth and age of children. Further development of FCHD leads to the more severe disorders of lungs, to the displacement and rotation of a heart, as a result -to the decompensation of cardiovascular and respiratory systems [4,6]. Etiology of FCHD in the modern time is not research enough, but the major role in its development plays such factors as: hereditary predisposition, genetic defects.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of the Funnel Chest Deformation at the Children

Andreevich¹

2017

AJP

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Abstract:Introduction: Funnel chest deformation (FCHD) is the most common malformation of the chest. This anomaly appears as the cosmetic and functional disorders of the cardiovascular and respiratory systems. Its main characteristic feature is tendency to progression, closely linked with the growth and age of children. Purpose: To analyze results of surgical treatment at the children with FCHD, using minimally invasive method of thoracoplasty. Materials and methods: The research group included 21 children with FCHD at the age from 4 to 17 years. Symmetrical shape of deformation was revealed in 14 patients (66.6%), the asymmetric shape was revealed in 5 (23.8%) patients, the FCHD -in 2 children (9.5%). Preoperative examination included: routine clinical laboratory research, spirography, electrocardiography, echocardiography, chest radiography in the frontal and lateral projections and computed tomography. All patients underwent thoracoplasty with using method D. Nuss. Results: The period of supervision covered from 6 months to 4 years after surgery operation. Good results were obtained in 17 (80.96%) cases; satisfactory -in 3 cases (14.28%), unsatisfactory -in 1 case (4.76%). Conclusion: Surgical treatment of FCHD with using innovative in Ukraine method of retrosternal metal fixators -is vital importance direction in thoracoplasty, having numerous advantages, compared with resection techniques, as well as minimally invasive and a good cosmetic effect.

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Minimally Invasive Repair of Pectus Excavatum - The Nuss Procedure. A European Multicentre Experience

Cited by 105 publications

References 4 publications

Can absorbable stabilizers be used routinely in the Nuss procedure?☆

Can absorbable stabilizers be used routinely in the Nuss procedure?☆

The vacuum bell for conservative treatment of pectus excavatum: the Basle experience

Surgical Treatment of the Funnel Chest Deformation at the Children

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