KẾT QUẢ PHẪU THUẬT NUSS ỨNG DỤNG NỘI SOI 3D ĐIỀU TRỊ BỆNH LÕM NGỰC BẨM SINH Ở TRẺ EM

Abstract

Objective: Describe the outcomes of the NUSS procedure in the treatment of pectus excavatum. Summary: Pectus excavatum (PE) is a congenital deformity caused by abnormal development of the sternum and ribs, affecting 0.6% of live births and is commonly found in males. The condition is typically detected in infancy, initially causing psychological effects due to the abnormality of the chest, and later impacting on respiratory and circulatory functions. The NUSS procedure, first described by Donald Nuss in 1986, involves using a metal bar to elevate the sternum. Since then, this technique has become popular worldwide for treating this defect. In order to assess the outcomes of this surgery, we have conducted a study. Method: Retrospective study. From January 2019 to October 2024, there were 40 patients (aged ≤ 15 years old), including 2 patients under 6 years old and 2 patients who had undergone open-heart surgery via sternotomy. Also, there were 36 patients who had symmetric pectus excavatum and 4 patients who had asymmetric pectus excavatum. The median of Haller index was 3.8, with 48% of cases being classified as severity level. Results: All patients underwent NUSS procedure with 3D endoscopic assistance. Thirty nine patients used one bar, while one patient used two bars. Mean operation time was 43 minutes and the median duration of mechanical ventilation was 40 minutes. There were no patient death. The treatment results before discharge showed that 37 patients had good results, while 3 patients had mild pectus excavatum. The average follow-up duration was 21 months. One patient required reoperation after 2 months because of the bar displacement. Four patients had their bars removed 3 years after the surgery. Conclusion: The NUSS procedure with 3D endoscopic assistance in the treatment of PE provides good results.