Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients

Croitoru, Daniel P.; Kelly, Robert E.; Goretsky, Michael J.; Lawson, M. Louise; Swoveland, Barbara; Nuss, Donald L.

doi:10.1053/jpsu.2002.30851

Cited by 312 publications

(270 citation statements)

References 27 publications

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“…The indications for surgical repair were 2 or more of the following criteria demonstrated by Dr. Nuss: (1) progression of the deformity; (2) exercise intolerance; (3) progressive chest pain or dyspnea; (4) restrictive ventilatory impairment; (5) Haller index >3.25; (6) cardiac compression (7) mitral valve prolapsed. 9,10) The demographic data, clinical data, complications, and surgical outcome were collected. This study was approved by the Ethics Committee and the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (TSGH-IRB No: 098-05-244).…”

Section: Methodsmentioning

confidence: 99%

Pleural Effusion Complicating after Nuss Procedure for Pectus Excavatum

Cheng

Lin

Wang

et al. 2014

Ann Thorac Cardiovasc Surg

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Purpose: The Nuss procedure is a minimally invasive method for the correction of pectus excavatum (PE). Pleural effusion complicating following the Nuss procedure was uncommon but may be critical. We evaluated the risk factors of postoperative pleural effusion after Nuss repair. Methods: We included all patients with PE primarily corrected by Nuss procedure from July 2005 to December 2011. The clinical features, treatment and outcomes of these patients with pleural effusion were analyzed retrospectively. Results: 390 patients (338 men, 52 women) with a mean age of 23.9 years (5-44 years) were included. Postoperative pleural effusion occurred in 10 patients (2.6%). The time of occurrence of pleural effusion was on a mean of 16.6 days (8-32 days) after operation presenting with progressive dyspnea. All of these patients were adults, and 9 patients (90%) were repaired by two pectus bars (p <0.001). Six patients with massive pleural effusion received thoracocentesis (400 ml-1000 ml). All of the effusions were exudative. These patients took short-term indomethacin or steroids without removal of bars and all recovered well after a mean of 40 months (12-72 months) follow-up. Conclusions: Pleural effusion complicating after Nuss procedure was uncommon. It occurred most on adult patients with placement of double bars. Close follow-up in adults after more than one bar insertion is recommended. Administration of temporary medications of indomethacin/steroid and/or thoracocentesis could obtain a satisfying result. Early administration of indomethacin/steroid in adult patients repaired by two bars with mild pleural effusion for preventing pooling of effusion could also be considered.

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Section: Methodsmentioning

confidence: 99%

Pleural Effusion Complicating after Nuss Procedure for Pectus Excavatum

Cheng

Lin

Wang

et al. 2014

Ann Thorac Cardiovasc Surg

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“…Good result means persisted minimal excavation of the sternum or other deformations of the ribs. Poor result is a recurrence of the defect (11). In the analyzed series very good results were obtained in 101 (72%) of children, good in 32 (23%) and bad in 7 (5%) children.…”

Section: Resultsmentioning

confidence: 82%

“…Both methods have been modified many times (11,16,17,18). Besides these two techniques, other ones have been proposed in recent years: nonsurgical method by means of suction (19,20), chest correction utilizing implants (5, 21), sternal retraction (22) and sternal stabilization by unabsorbable net (23).…”

Section: Discussionmentioning

confidence: 99%

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The Nuss Procedure for the Correction of Pectus Excavatum

Bohosiewicz¹,

Kudela²,

Izwaryn³

2009

Polish Journal of Surgery

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Pectus excavatum is one of the most common chest malformation. It occurs 4-5 times more often in boys. Familiar occurrence of the malformation has been observed. Two surgical techniques have been performed predominantly: the Ravitch method (1949) with further modifications and the Nuss minimally invasive method (1998). The aim of the study was presentation of our own, slightly modified surgical technique, its results and original analgesia method in early postoperative period. results. Very good result was achieved in 72%, good in 22% and bad in 5%. No mortality and inner organ injuries were noticed. Minor complications occurred in 12% of children. conclusions. The Nuss procedure for the correction of pectus excavatum gives good and very good results in 94% of children. The minimal invasiveness of this method allows to use this method for minor defects. The limitation of this technique is asymmetric defect in which the Ravitch procedure is still the method of choice.

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“…In 1998, a new technique of minimally invasive repair of PE (MIRPE) was first described by D. 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 short operating time, smaller incisions and considerably less dissection has 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 in an increase of the number of PE repairs.…”

Section: Introductionmentioning

confidence: 99%

The Vacuum Bell For Treatment Of Pectus Excavatum: An Effectıve Tool For Conservatıve Therapy

Haecker¹

2011

Toraks Cer Bult

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Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients

Cited by 312 publications

References 27 publications

Pleural Effusion Complicating after Nuss Procedure for Pectus Excavatum

Pleural Effusion Complicating after Nuss Procedure for Pectus Excavatum

The Nuss Procedure for the Correction of Pectus Excavatum

The Vacuum Bell For Treatment Of Pectus Excavatum: An Effectıve Tool For Conservatıve Therapy

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