小儿复杂性先天性漏斗胸及合并症的手术治疗

目的]总结小儿复杂性先天性漏斗胸合并其他疾病的手术治疗及术后并发症的处理.方法]2007年7月至2011年8月,采用胸腔下行改良NUSS手术矫治复杂性漏斗胸30例,并对合并疾病同期处理.其中合并扁平胸7例,漏斗胸再发3例,严重不对称10例,脊柱侧弯5例,不对称并脊柱侧弯3例,多发肺囊肿1例,肺大疱1例.30例患儿单...

Surgical Treatment of Complex Congenital Funnel Chest in Children and Its Complications

Objective]To summarize the surgical treatment of complex congenital funnel chest combined with other diseases in children and the treatment of postoperative complications. Methods] From July 2007 to August 2011, 30 cases of complex congenital funnel chest underwent the modified NUSS procedure under thoracoscopy. Meanwhile, the complications were treated. Among them, there were 7 cases complicated with flat chest, 3 cases with the recurrence of funnel chest, 10 cases with severe asymmetry, 5 cases with scoliosis, 3 cases with asymmetry and scoliosis, 1 case with multiple lung cysts and 1 case with bullae. Other 30 patients with simple funnel chest underwent NUSS procedure. They were compared. Results] In the complex group, the operative time was 30-78min（42±11.5min） and the intraoperative bleeding volume was less than 15ml. There was no significant statistical difference between complex group and control group. All 30 pediatric patients were successfully operated. No death and other complications such as bleeding and thoracic organ injury were found. Patients were followed up for 3-28 months. There was no difference in the activity tolerance between these patients and normal children with the same age. Postoperative pneumothorax with subcutaneous emphysema occurred in one case. Small amount of pleural effusion occurred in one case. Two cases had wound swelling after 6 months. One case with the change of plate position underwent the operation again and had satisfactory result. There was no significant statistical difference in the complications between the patients in complex group and the patients with simple funnel chest undergoing NUSS procedure at the same period. Conclusion] Individual modified NUSS surgery for complex funnel chest has good effect. The treatment result of the complications at the same stage is satisfactory.