Modifications and Further Development of the Original Nuss Procedure: Blessing or Curse?

Kelly, Robert E.

doi:10.1055/s-0038-1668564

Cited by 7 publications

(4 citation statements)

References 56 publications

(52 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consulting literature, a series of modifications focused on the parts of measuring the chest, bar selection and configuration, marking the patient, thoracoscopy, subcutaneous tunneling, substernal tunneling, sternal elevation, bar insertion and rotation, bar fixation, pneumothorax evacuation [ 17 ]. Anthony I. Squillaro et al [ 18 ] emphasized the importance of chest introducer entry and exit sites as a critical operative step, which is a novel alternative approach to asymmetric pectus excavatum repair.…”

Section: Discussionmentioning

confidence: 99%

Modified bar bending method of thoracoscopic nuss procedure on pectus excavatum: a retrospective single-center study

et al. 2023

View full text Add to dashboard Cite

Background Pectus excavatum (PE) is the most common disease of chest wall deformity, with an incidence of 1 in 300—400 births. Nuss procedure has proved to be the best surgical treatment method and has been widely used after clinical use for 30 years. We aimed to review the clinical data of pectus excavatum (PE) of thoracoscopic Nuss procedure adopted the Modified bar bending method of the six-point seven-section type, and compare it with the traditional curved bar bending method to explore the clinical application effect. Methods Forty-six cases of clinical data were summarized of children with PE who adopted the treatment of the Modified bar bending method of the six-point seven-section type from January 2019 to December 2021, and 51 cases were compared of PE children who adopted the treatment of traditional curved bar bending method from January 2016 to December 2018, including the data of age, gender, preoperative symptoms, symmetry, Haller index, operation time, bar bending time, intraoperative bleeding, postoperative complications, bar migration, postoperative effect evaluation, etc. Results The Procedure duration (P = 0.008), bar bending time (P < 0.001), and duration of postoperative pain (P < 0.001) were reduced significantly, and the incidence of bar migration after surgery was reduced as well by the modified bar bending method. There was no difference compared with traditional Nuss produce, like the incidence of evaluation of postoperative effects (Excellent, P = 0.93; Good, P = 0.80; Medium, P = 1.00; Poor, P = 1.00), bar migration (P = 1.00), postoperative complications (P = 1.00), Clavien- Dindo classification of surgical complications (I = 0.165; II = 1.00; IIIa = 1.00; IIIb = 1.00; VI = 1.00; V = 1.00), operative safety, and operative validity. Conclusion Modified bar bending method of the six-point seven-section type, which is a kind of surgical method worth applying and popularizing, and the advantages of minimally procedure duration, bar bending time, and duration of postoperative pain, compared with the traditional bar bending method.

show abstract

Section: Discussionmentioning

confidence: 99%

Modified bar bending method of thoracoscopic nuss procedure on pectus excavatum: a retrospective single-center study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…There are some reported cases of cardiac perforation and other organ injury [39,40,42], although the overall incidence of life-threatening complications of minimally invasive pectus surgery is estimated to be less than 0.1% [43]. Many modifications have been described focusing on reducing the risk of complications, improving the aesthetics, pain control [44], or adapting to new circumstances, such as use in adults whose chest is not as flexible [45]. The study by Molik et al in 2001 found a displacement of the metalwork in 11% of cases and a re-operation in 29% of cases, with other causes including infection, hemothorax, pain, and the development of secondary pectus carinatum.…”

Section: Discussionmentioning

confidence: 99%

Minimalized Erlangen Correction Method by Hümmer (MEK) Compared with Conventional and Minimally Invasive Correction Methods for Pectus Excavatum Single Center Experience

Denzinger,

Reis Wolfertstetter,

Sossau

et al. 2023

Applied Sciences

View full text Add to dashboard Cite

Pectus excavatum (funnel chest) is the most common chest wall deformity in childhood and adolescence with a prevalence in the literature ranging from 1 in 3400 to 1 in 1000. In addition to conservative therapy with a suction cup and physiotherapy to improve posture, fitness, and muscle strength, there are several different surgical techniques, many of which have been improved over time. In evaluating the Minimalized Erlangen Correction Method (MEK), the main purpose of this retrospective analysis is to present the results and to compare them with reports on the Minimally Invasive Repair of Pectus Excavatum (MIRPE) technique, especially regarding long-term patient satisfaction, and with other open surgical methods in terms of operative trauma, as well as flexibility in its application, risk of complications, and patient safety.

show abstract

“…Since the introduction of the minimally invasive repair of pectus excavatum (MIRPE) by Dr. Donald Nuss to the American Pediatric Surgical Association in 1998, the MIRPE procedure is widely accepted as a method of pectus excavatum (PE) chest wall deformity repair (1,2). For many surgeons, this approach is preferable to the alternative method of repair involving resection of costal cartilage and sternal fracture, described by Ravitch in 1949 (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Pectus repair after prior sternotomy: clinical practice review and practice recommendations based on a 2,200-patient database

Kenney¹,

Obermeyer²

2023

J Thorac Dis

View full text Add to dashboard Cite

The minimally invasive repair of pectus excavatum (MIRPE) is widely accepted as a method of pectus excavatum (PE) repair. Repair is rarely performed in patients with a history of median sternotomy.A feared complication of this procedure is iatrogenic cardiac injury; the risk of injury in patients with prior sternotomy is especially high due to the development of post-surgical retrosternal adhesions, which obscures the "critical view" during MIRPE. A 14-center review reported the incidence to be as high as 7% after analyzing 75 patients with history of sternotomy who underwent MIRPE. Little literature exists on how to best prepare for MIRPE in patients with prior sternotomy. A review of the literature and a retrospective review of over 2,200 patients who underwent MIRPE at our institution was performed to analyze 9 patients who underwent MIRPE after prior sternotomy. Iatrogenic cardiac injury occurred in 2 patients. Given the infrequency in our experience and the low numbers reported in the literature, statistical conclusions cannot be drawn. However, prudent strategies based on this experience include thoracoscopy, routine sternal elevation, direct sub-xiphoid retrosternal dissection, coordination with cardio-thoracic surgeons, preparation for cardio-pulmonary bypass, and massive transfusion protocol availability to optimize surgical outcomes in patients undergoing MIRPE with a history of sternotomy.

show abstract

Modifications and Further Development of the Original Nuss Procedure: Blessing or Curse?

Cited by 7 publications

References 56 publications

Modified bar bending method of thoracoscopic nuss procedure on pectus excavatum: a retrospective single-center study

Modified bar bending method of thoracoscopic nuss procedure on pectus excavatum: a retrospective single-center study

Minimalized Erlangen Correction Method by Hümmer (MEK) Compared with Conventional and Minimally Invasive Correction Methods for Pectus Excavatum Single Center Experience

Pectus repair after prior sternotomy: clinical practice review and practice recommendations based on a 2,200-patient database

Contact Info

Product

Resources

About