Nuss Procedure: Decrease in Bar Movement Requiring Reoperation with Primary Placement of Two Bars

Stanfill, Amy B.; DiSomma, Nerina M.; Henriques, Steven M.; Wallace, Lizabeth J.; Vegunta, Ravindra K.; Pearl, Richard H.

doi:10.1089/lap.2011.0080

Cited by 22 publications

(25 citation statements)

References 14 publications

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“…In repairing adult or teenager pectus deformities, many surgeons prefer to use 2 bars [12,13], believing that multiples bars better disperses pressure, resulting in improved bar security. We have relied on a similar policy since the beginning of our series in 1999, which we refer to as the parallel bar technique [6] but with a different rationale.…”

Section: Discussionmentioning

confidence: 99%

The bridge technique for pectus bar fixation: a method to make the bar un-rotatable

Park

Kim

Moon

et al. 2015

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

The bridge technique for pectus bar fixation: a method to make the bar un-rotatable

Park

Kim

Moon

et al. 2015

Journal of Pediatric Surgery

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“…This finding is consistent with previous studies that mentioned the need for doublebar insertion in late adolescents and adults. [4,17,18] Yoon et al [18] wrote that double-bar insertion might be more stable for late adolescent and adult patients. The chest wall size of adults is larger than that of children, so it is relatively difficult to correct pectus excavatum via single-bar insertion.…”

Section: Original Articlementioning

confidence: 99%

Radiologic factors related to double-bar insertion in minimal invasive repair of pectus excavatum

Kim

Lee

et al. 2014

World J Pediatr

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“…In the treatment of PE, the stability of the metal bar in the thorax is improved, and there is no need for re-surgical intervention when 2 metal rods are implanted in the rst surgery. The use of two metal bars during the rst treatment has become the standard of minimally invasive surgery for PE [1], [23], [24].…”

Section: Discussionmentioning

confidence: 99%

365 Patients with Pectus Excavatum Undergoing Video-Assisted Thoracoscopic Surgery for the Nuss Procedure: A 5-Year Single-Institution Experience

Uoc¹,

Lu²,

Sơn³

et al. 2020

Preprint

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Objective: We conducted this study to review our large single-center experience in Vietnam in the use of the VATS-NUSS for 365 consecutive patients with PE within the five years and to evaluate mid-term to long-term outcome in these patients. Methods: In this retrospective study, we consecutively selected the patients with the diagnosis of PE who underwent VATS-NUSS from January 2015 to September 2019. A total of 365 patients who were surgically treated for PE at the Department of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital (Hanoi, Vietnam) was included in final analysis. Results: The length of postoperative hospitalization ranged from 1 to 13 days (Mean: 5.1). Early postoperative complications were recorded up to 30 days during hospital stay, consisting of pneumothorax (n = 5, 1.37%), pleural bleeding / pleural fluid (n = 2, 0.55%), pleural hematoma (n = 1, 0.27%), pneumonia (n = 1, 0.27%), surgical wound infection (n = 1, 0.27%), incision fluid accumulation (n = 3, 0.82%), metal bar infection (n = 1, 0.27%), atelectasis (n = 3, 0.82%), and fever (n = 8, 2.19%). In the late postoperative complications, surgical wound infection (n = 2, 0.55%), metal bar deviation (n = 5, 1.37%), metal bar allergy (n = 10, 2.74%), recurrent PE (n = 2, 0.55%), and persistent PE (n = 5, 1.37%) were observed. No deaths occurred. The outcomes related to the bar removal that was carried out in 175 patients (47.95%). The time the bar was in situ ranged from 2 to 49 months (mean: 28.89±7.48 years). The mean operative time at bar removal was 34.09 ± 10.61 minutes, and the length of hospitalization following bar removal was 2.4 ± 1.34 days. Of 175 patients performed bar removal, the most frequent complication was pneumothorax, which was diagnosed in 19 (10.85%) patients; surgical wound infection in 1 patient and incision fluid accumulation in 1 patient were observed following bar removal. Towards mid-term results at 6 – 30 months postoperatively, there were 124 out of 365 patients (33.97%). Of 124 patients, most patients were unremoved the bar (n = 121, 97.58%), and only 3 patients were removed the bar (2.42%). Most patients had body weight gain (n = 97, 78.23%), and increased physical activity and improved health (n = 115, 92.74%). The Haller index on chest X-ray was 2.44 ± 0.15. 220 out of 365 patients (60.27%) were postoperatively evaluated long-term results at over 30 months. Of those, 172 received bar removal (78.18%) and 48 have not yet received bar removal (21.82%). 217 patients (98.64%) had both body weight gain, and increased physical activity and improved health. The Haller index on chest X-ray was 2.45±0.21. Conclusions: The VATS-NUSS for PE was safe and effective approach with minimizing the occurrence of serious intra- and postoperative complications. From our initial one-institution experience in a resource-scare country, good mid-term to long-term postoperative outcomes in PE patients were obtained with VATS-NUSS. Current rare evidence drawn from this cohort enables to give a real picture in the application, modification and development of VATS-NUSS not only for Vietnam but also the countries having similar resource-scare conditions.

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Nuss Procedure: Decrease in Bar Movement Requiring Reoperation with Primary Placement of Two Bars

Cited by 22 publications

References 14 publications

The bridge technique for pectus bar fixation: a method to make the bar un-rotatable

The bridge technique for pectus bar fixation: a method to make the bar un-rotatable

Radiologic factors related to double-bar insertion in minimal invasive repair of pectus excavatum

365 Patients with Pectus Excavatum Undergoing Video-Assisted Thoracoscopic Surgery for the Nuss Procedure: A 5-Year Single-Institution Experience

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