微创改良胸肋抬举术治疗漏斗胸

目的探讨微创改良胸肋抬举术治疗儿童先天性漏斗胸的安全性和疗效。方法回顾性分析先天性漏斗胸患儿50例,男35例,女15例。其中不对称漏斗胸11例,合并肋缘外翻畸形8例。均行微创改良胸肋抬举术,即胸壁纵行小切口,长3～5cm,V型横断胸骨保留其后骨膜连续完整,间断切除肋软骨,保留骨膜连续完整,折叠、缩短缝合肋骨骨膜,抬举并固定胸骨,从而矫治漏斗胸。结果术后胸骨平均抬高3.1(1.5～5.0)cm,平均胸脊距为6.2(4.0～9.7)cm。随访3～24个月,漏斗胸均获矫正,8例肋缘外翻畸形矫正满意,仅1例患儿遗留胸壁不对称及扁平胸。未发现严重并发症。结论微创改良胸肋抬举术治疗儿童先天性漏斗胸创伤小、并发症少,是安全、有效的,值得推广。

Minimally invasive surgical treatment of improved costa sternales lifts in treatment of congenital funnel chest

Objective To investigate the safety and effect of minimally invasive surgical treatment of improved costa sternales lifts in treatment the children with congenital funnel chest.Methods Fifty patients were retrospectively evaluated with congenital funnel chest including the males(n=35) and females(n=15).There were eleven patients with asymmetric funnel chest and eight patients combined with costal margin holds the deformity.All the patients were enforced the minimally invasive costa sternales lifts technique.The improvement was a small longitudinal incision on the chest wall about 3～5cm.Intersecting sternum with the V-type keeped continuous complete and continuous periosteum after resection of cartilage.We exalted the fixed sternum after keepping the continuous rib periosteum and shortting the periosteum complete ribs.Results The sternum raised about an average of 3.1(1.5～5.0)cm and the average spinula between sternum and spine was about 6.2(4.0～9.7)cm.Follow-up 3～24months,funnel chest of all the patients were corrected and eight patients combined with costal margin were corrected satisfactorily.Only one patient left chest wall asymmetry and flat chest.Serious complication was not observed.Conclusions The minimally invasive surgical treatment of improved costa sternales lifts in treatment of the children with congenital funnel chest may be a safe and effective method with small trauma and few complications and may be worthy to be popularized.