胸腔镜辅助胸骨抬举加倒T形内固定术矫治漏斗胸

目的探讨胸腔镜辅助下胸骨抬举术加倒T形内固定法矫治漏斗胸的方法及优点。方法2003年3月~2005年3月,采用电视胸腔镜辅助胸骨抬举加倒T形内固定法矫治漏斗胸36例,其中男27例,女9例。平均年龄4.36岁(2岁2个月~10岁)。平均漏斗胸指数(F2I)为0.28(0.21~0.6)。切口平均长度3.8cm。结果全组均恢复顺利。胸骨凹陷最低点较术前抬高幅度1.9~5.5cm,平均3.4cm。除2例原有扁平胸外,其余胸廓外形全部恢复正常。术后随访2年,2例小范围肋软骨凹陷,其余34例胸廓外观平整无凹陷,内固定无移位。结论胸腔镜辅助胸骨抬举加倒T形内固定法矫治漏斗胸切口小,创伤小,并发症少,疗效好,是一种理想的治疗方法。

A minimally invasive technique: thoracoscopic assisted combination of sternal elevation and reverse Tshape internal fixation for pectus excavatum.

Objective To discuss the advantages of the minimally invasive thoracoscopic assisted sternal elevation and reverse T shape internal fixation for the correction of pectus excavatum. Methods From Mar 2003 to Mar 2005, 36 cases of pectus excavatum (male 27, female 9), age ranged from 2 years and 2 months to 10 years (mean age 4.36 years), were treated with the procedure of the minimally invasive thoracoscopic assisted sternal elevation and reverse T shape internal fixation. The F2I were 0.21~0.6 (0.28). The average wound length was 3.8 cm. Results All patients were recovered uneventfully. The lowest sternum points were elevated to the desired position, the average elevation was 3.4 cm (varied from 1.9~5.5 cm). With exception of 2 patients had a flat contour in thorax, all patients had the normal thoracic contour. The follow-up period was 2 years postoperatively, 34 cases thoracic cage form were neat, internal fixation was no displacement the costal cartilage excavation in small range was observed only in 2 patients. Conclusions Our procedure has minimal invasion, a litter trauma and satisfing efficacy etc advantages and can be considered, as an ideal treatment for the correction for pectus excavatum.