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The Nuss Procedure for the Correction of Pectus Excavatum

100%

Bohosiewicz J., Kudela G., Izwaryn U.

Polish Journal of Surgery

2009

vol. 81

issue 2

103-112

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.Material and methods. 190 Nuss procedures have been performer in years 1998-2008. 140 children operated on for the period of 8 years have been analyzed. A slightly modified surgical method and original postoperation intrapleural analgesia method have been presented. No thoracoscopy and no lateral stabilizations have been used. The Haller index of operated children was 2.2-5.8. The children's age was 4-18 years, av. 14 years. An average operation time was 40 min and 80 min together with anesthesia.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.

An Effect of Nuss Procedure on Lung Function Among Patients with Pectus Excavatum

100%

Szydlik S., Jankowska-Szydlik J., Kasprzyk M., Dyszkiewicz W., Adamczak J., Zwaruń D.

Polish Journal of Surgery

2013

vol. 85

issue 1

1-5

The aim of the studywas to evaluate lung function among patients who underwent Nuss Procedure. The analysis included spirometric evaluation of the lung function before Nuss Procedure, during perioperative period and after removing steel bars from behind the sternum. Material and methods.The study group involved patients operated on the pectus excavatum in the Department of Thoracic Surgery in Poznań in years 2002-2004. The study group consisted of 44 patients (5 females and 39 males). Aged between 10 to 32 years old, the mean age was 16. The following spirometric parameters were analysed: vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), FEV1/VC ratio, peak expiratory flow (PEF), forced expiratory flow for 25% (FEF25), 50% (FEF50) and 75% FVC (FEF75). Results.The values of the FVC, FEV1, FEF25, and FEV1/VC ratio in the study group were significantly higher in the postoperative period in comparison with the preoperative period. There was a statistically significant correlation between the improvement in spirometric parameters after Nuss Procedure and the impairment of spirometric values in preoperative period. There were no statistical differences between the value of initial chest deformation and spirometric parameters improvement. There were also no statistically significant correlations between age, height and weight of the patient in the study group and spirometric values improvement. Conclusion.There is a statistical improvement in lung function in patients who underwent Nuss Procedure. The improvement in spirometric parameters correlates with the impairment of spirometric values in the preoperative period.

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2 Polish Journal of Surgery

1 2013

1 2009

1 Adamczak J.

1 Bohosiewicz J.

1 Dyszkiewicz W.

1 Izwaryn U.

1 Jankowska-Szydlik J.

1 Kasprzyk M.

1 Kudela G.

1 Szydlik S.

1 Zwaruń D.

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The Nuss Procedure for the Correction of Pectus Excavatum

An Effect of Nuss Procedure on Lung Function Among Patients with Pectus Excavatum