Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was ca...Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was carried out for evaluation of the deformity degree and morphology classification of chest wall malformation,展开更多
Objective To investigate the indication,feasibility and technique of minimally invasive Nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence....Objective To investigate the indication,feasibility and technique of minimally invasive Nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls,suffered from pectus excavtum were corrected by Nuss procedure under thoracoscope. The average age展开更多
A 19-year-old male patient who suffered from sudden and repeated multiple organ dysfunction syndrome one month after the bar removal procedure of Nuss surgery for pectus excavatum was admitted to our department.With o...A 19-year-old male patient who suffered from sudden and repeated multiple organ dysfunction syndrome one month after the bar removal procedure of Nuss surgery for pectus excavatum was admitted to our department.With organ function supportive treatment,the etiology was finally identified to be a bone spur located at the inner border of the left costa due to repeated friction between the implanted steel bar and the rib,which damaged the heart repeatedly and induced the consequent acute cardiac tamponade.After operation,the patient was successfully managed and discharged.Follow-ups till three years indicated a good recovery.展开更多
Objective:To investigate the clinical efficacy and safety of the extrapleural approach versus the traditional intrathoracic approach in minimally invasive correction of pectus excavatum in children,providing a more sc...Objective:To investigate the clinical efficacy and safety of the extrapleural approach versus the traditional intrathoracic approach in minimally invasive correction of pectus excavatum in children,providing a more scientific basis for selecting a more appropriate surgical method in clinical practice.Methods:This study included 50 children who underwent pectus excavatum correction at Harbin Children’s Hospital from January 2023 to January 2025.All patients were divided into two groups based on surgical approach:the observation group(n=26)and the control group(n=24).Children in the observation group underwent correction surgery via an extrapleural approach,while those in the control group underwent correction surgery via the traditional intrathoracic approach.Both groups underwent Nuss bar placement surgery under thoracoscopic guidance.Intraoperative indicators were compared between the two groups,including operative time,blood loss,pain scores at 24 and 48 hours postoperatively,hospital stay duration,thoracic correction outcomes,and the incidence of complications during a 6-month postoperative follow-up.Results:The intraoperative blood loss in the observation group was significantly lower than that in the control group(p<0.05),and the pain scores at 24 and 28 hours postoperatively were also significantly lower(p<0.05).The improvement in thoracic index postoperatively was relatively similar between the two groups,with no statistically significant difference(p>0.05).During the 6-month postoperative follow-up period,no complications such as pneumothorax,hemothorax,pleural effusion,plate displacement,or infection occurred in the observation group,whereas the overall complication rate in the control group was 25%,showing a significant difference(p<0.05).Conclusion:The extrapleural approach for corrective surgery can ensure the efficacy of thoracic deformity correction while reducing intraoperative blood loss,lowering the incidence of complications,alleviating postoperative pain,and accelerating recovery.It is a safe and effective approach for minimally invasive Nuss correction of pediatric pectus excavatum.展开更多
Background:Pectus excavatum is the most common congenital chest wall deformity,with a high incidence in live births.This study aimed to evaluate the measured factors on CT images related to the number of pectus bars f...Background:Pectus excavatum is the most common congenital chest wall deformity,with a high incidence in live births.This study aimed to evaluate the measured factors on CT images related to the number of pectus bars for surgical correction.Methods:A total of 497 patients who had undergone minimally invasive repair between April 2007 and July 2011 were classified into single-bar(n=358)and doublebar(n=139)insertion groups.We measured eight distinct distances and one angle on CT scans to reflect quantitative assessment.Univariate analysis and multivariate logistic regression analysis were performed to detect statistically significant association between radiologic measurements and the pectus bars required.Results:After adjusting for age and gender,the transverse distance(T),the transverse distance of the depression area(A),the inclined distance of the depression area(B),the AP distance of the depression area(C),the depression angle(G),and the eccentric distance of deformity(E)were significantly correlated with double-bar insertion.The regression model showed that age(,P<0.0001),gender(P<0.0001),depression angle(G)(P<0.0001),direction of the depression(DD)(P<O.OOO1)and depression depth(D)(P<0.0001)were significantly associated with doublebar insertion.Conclusion:CT scan provides useful factors which can be of assistance in predicting the number of pectus bars for the surgical correction of pectus excavatum.展开更多
Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents＇ psychological and behavior. This study aimed to investigate the psychological characteristics and factors that a...Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents＇ psychological and behavior. This study aimed to investigate the psychological characteristics and factors that affect adolescents with funnel chest and to evaluate the relationship between the patients＇ age and their physiological and psychological health. We aimed to establish an age model for maximum surgery benefits for funnel chest patients to provide an objective basis for choosing surgery. Methods The study adopted a general evaluation approach to assess the risk and benefits of minimally invasive surgery for funnel chest. The funnel chest index, the Symptom Checklist-90, and the Eysenck Personality Questionnaire were used as assessment tools to observe physiological and psychological features in funnel chest patients. A sample of 234 adolescents with funnel chest was selected from a third-grade class-A hospital in Beijing. Age groups were adopted as an independent variable, and other factors in funnel chest patients were dependent variables. Results There was a significant difference in the relapse rate for funnel chest in the different age groups （X2=11.883, P=-O.008）. There was a higher relapse rate in patients of 〈10 or 〉-19 years old than in patients of 11-18 years old. There was a significant difference in the SCL-90 total score in the different age groups （F=12.538, P=-0.0001）, the patients older than 13 years had a higher score than those younger than 13 years in the SCL-90. There was a significant difference in the standard score of E （introversion/extraversion） in the different age groups （F=10.06, P=0.0001）. There was also a significance in the funnel chest index before surgery in the different psychological scales （P〈0.01）, with a higher funnel chest index score associated with more obvious psychological trauma. Age and the number of variables, including the relapse rate, SCL-90 score, standard score of E, and standard score of N in the EPQ were significantly correlated （correlation indices were 0.402, 0.623, -0.505, and 0.473, respectively, P〈0.01）. Conclusions There are higher complication rates after surgery and relapse rates when funne{ chest patients are too young or too old. There is more obvious psychological trauma in patients with a high funnel chest index. Our results indicate that the best age for surgery for funnel chest is 14-16 years.展开更多
文摘Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was carried out for evaluation of the deformity degree and morphology classification of chest wall malformation,
文摘Objective To investigate the indication,feasibility and technique of minimally invasive Nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls,suffered from pectus excavtum were corrected by Nuss procedure under thoracoscope. The average age
文摘A 19-year-old male patient who suffered from sudden and repeated multiple organ dysfunction syndrome one month after the bar removal procedure of Nuss surgery for pectus excavatum was admitted to our department.With organ function supportive treatment,the etiology was finally identified to be a bone spur located at the inner border of the left costa due to repeated friction between the implanted steel bar and the rib,which damaged the heart repeatedly and induced the consequent acute cardiac tamponade.After operation,the patient was successfully managed and discharged.Follow-ups till three years indicated a good recovery.
基金Research on Surgical Strategies for the Correction of Pectus Excavatum in Children via an Extrapleural Approach(Project No.:20220404021010)。
文摘Objective:To investigate the clinical efficacy and safety of the extrapleural approach versus the traditional intrathoracic approach in minimally invasive correction of pectus excavatum in children,providing a more scientific basis for selecting a more appropriate surgical method in clinical practice.Methods:This study included 50 children who underwent pectus excavatum correction at Harbin Children’s Hospital from January 2023 to January 2025.All patients were divided into two groups based on surgical approach:the observation group(n=26)and the control group(n=24).Children in the observation group underwent correction surgery via an extrapleural approach,while those in the control group underwent correction surgery via the traditional intrathoracic approach.Both groups underwent Nuss bar placement surgery under thoracoscopic guidance.Intraoperative indicators were compared between the two groups,including operative time,blood loss,pain scores at 24 and 48 hours postoperatively,hospital stay duration,thoracic correction outcomes,and the incidence of complications during a 6-month postoperative follow-up.Results:The intraoperative blood loss in the observation group was significantly lower than that in the control group(p<0.05),and the pain scores at 24 and 28 hours postoperatively were also significantly lower(p<0.05).The improvement in thoracic index postoperatively was relatively similar between the two groups,with no statistically significant difference(p>0.05).During the 6-month postoperative follow-up period,no complications such as pneumothorax,hemothorax,pleural effusion,plate displacement,or infection occurred in the observation group,whereas the overall complication rate in the control group was 25%,showing a significant difference(p<0.05).Conclusion:The extrapleural approach for corrective surgery can ensure the efficacy of thoracic deformity correction while reducing intraoperative blood loss,lowering the incidence of complications,alleviating postoperative pain,and accelerating recovery.It is a safe and effective approach for minimally invasive Nuss correction of pediatric pectus excavatum.
基金supported by a grant from the Research Foundation of Korea University(K1220231)
文摘Background:Pectus excavatum is the most common congenital chest wall deformity,with a high incidence in live births.This study aimed to evaluate the measured factors on CT images related to the number of pectus bars for surgical correction.Methods:A total of 497 patients who had undergone minimally invasive repair between April 2007 and July 2011 were classified into single-bar(n=358)and doublebar(n=139)insertion groups.We measured eight distinct distances and one angle on CT scans to reflect quantitative assessment.Univariate analysis and multivariate logistic regression analysis were performed to detect statistically significant association between radiologic measurements and the pectus bars required.Results:After adjusting for age and gender,the transverse distance(T),the transverse distance of the depression area(A),the inclined distance of the depression area(B),the AP distance of the depression area(C),the depression angle(G),and the eccentric distance of deformity(E)were significantly correlated with double-bar insertion.The regression model showed that age(,P<0.0001),gender(P<0.0001),depression angle(G)(P<0.0001),direction of the depression(DD)(P<O.OOO1)and depression depth(D)(P<0.0001)were significantly associated with doublebar insertion.Conclusion:CT scan provides useful factors which can be of assistance in predicting the number of pectus bars for the surgical correction of pectus excavatum.
文摘Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents＇ psychological and behavior. This study aimed to investigate the psychological characteristics and factors that affect adolescents with funnel chest and to evaluate the relationship between the patients＇ age and their physiological and psychological health. We aimed to establish an age model for maximum surgery benefits for funnel chest patients to provide an objective basis for choosing surgery. Methods The study adopted a general evaluation approach to assess the risk and benefits of minimally invasive surgery for funnel chest. The funnel chest index, the Symptom Checklist-90, and the Eysenck Personality Questionnaire were used as assessment tools to observe physiological and psychological features in funnel chest patients. A sample of 234 adolescents with funnel chest was selected from a third-grade class-A hospital in Beijing. Age groups were adopted as an independent variable, and other factors in funnel chest patients were dependent variables. Results There was a significant difference in the relapse rate for funnel chest in the different age groups （X2=11.883, P=-O.008）. There was a higher relapse rate in patients of 〈10 or 〉-19 years old than in patients of 11-18 years old. There was a significant difference in the SCL-90 total score in the different age groups （F=12.538, P=-0.0001）, the patients older than 13 years had a higher score than those younger than 13 years in the SCL-90. There was a significant difference in the standard score of E （introversion/extraversion） in the different age groups （F=10.06, P=0.0001）. There was also a significance in the funnel chest index before surgery in the different psychological scales （P〈0.01）, with a higher funnel chest index score associated with more obvious psychological trauma. Age and the number of variables, including the relapse rate, SCL-90 score, standard score of E, and standard score of N in the EPQ were significantly correlated （correlation indices were 0.402, 0.623, -0.505, and 0.473, respectively, P〈0.01）. Conclusions There are higher complication rates after surgery and relapse rates when funne{ chest patients are too young or too old. There is more obvious psychological trauma in patients with a high funnel chest index. Our results indicate that the best age for surgery for funnel chest is 14-16 years.
