KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ LÕM NGỰC BẰNG THANH KÉP

Abstract

Objectives: Evaluating the results of surgical treatment of congenital pectus excavatum by Nuss procedure with sandwich technique using pair of metallic pectus bars. Methods: Retrospective- case series deciptive study conducted at Thoracic and Vascular Surgery Department, University Medical Center, Ho Chi Minh city. Results: from June 2016 to July 2022, there were 226 patients with congenital pectus excavatum treated with sandwich technique procedure using pair of metallic pectus bars, of which 190 men (84.1%) and 36 women (15.9%); Mean age 16.5 ± 4.9 (5 – 31); concentric pectus excavatum 158 cases (69.9%), eccentric pectus excavatum 68 cases (30.1%); The average Haller index pre-operation was 3.8 ± 0.6. All patients received 1 or 2 pairs of metallic pectus bars, the more severe pectus excavatum, the higher the rate of 2 pairs of metallic pectus bars placed (p = 0.048); The mean operative time 60.9 ± 19.5 minutes; The average period of hospitalization 5.0 ± 1.3 days. The mean Haller index postoperation 2.5 ± 0.2; majority of patients had fairy good results (2.5 < HI < 3.25) and good results (HI ≤ 2.5) with rates of 52.2% and 47.8%, respectively. Minor pectus excavatum had better results than the moderate and severe pectus excavatum groups (p = 0.001). Complications occurred mainly in the group with severe pectus excavatum: surgical wound infection 2 cases (0.9%), bar infection 2 cases (0.9%), and bar allergy 8 cases (3.5%). There were no cases of late bar displacement or need for redo-surgery. Conclusion: congenital pectus excavatum treated with sandwich technique procedure using pair of metallic pectus bars shows that 100% of patients have fairy good and good postoperative Haller Index. Surgical results were better in the mild pectus excavatum and concentric pectus excavatum groups. Surgery also shows that it is less invasive and has almost no intra-operative complications  or serious post-operative complications.