胸腔镜下微创漏斗胸矫正临床分析

目的总结胸腔镜下微创漏斗胸矫正（Nuss手术）治疗漏斗胸的临床经验。方法2006年12月至2008年7月，我院17例漏斗胸患者采用胸腔镜下Nuss手术进行矫治。分析这些患者的临床资料。结果17例均顺利完成手术，术中无并发症。术后随访6～20个月。15例钢板无松动，位置良好，矫正效果满意，2例患儿出现轻度移位。其他并发症包括1例术后感染，加强抗感染后痊愈；1例出现皮下积液，经穿刺抽液后痊愈；1例出现植入物反应。结论胸腔镜Nuss手术治疗漏斗胸安全有效，适用于对称性或不对称性漏斗胸患者。应注意预防感染和防止钢板移位。

Thoracoscopy-assisted Nuss procedure for 17 patients with pectus excavatum

Objective To summariz clinical experience and preliminary results of minimally invasive operationfor pectus excavatum repairing (Nnss procedure).Methods Seventeen patiens with pectus excavatum were surgically corrected by Nuss procedure during November 2006 to July 2008.Results Fifteen patients had complete procedure successfully without complications.The median operation time was 80 minutes (range from 50 to 185 minutes).The blood loss was less than 10 ml.There were not mediastinal injury,bleeding complications and requirement of chest tube insertion postoperatively.The mean length of hospital stay was 7.2 days.The follow-up period ranged from 6 to 20 months.There was no looseness of internal fixation and steel plate was well located with satisfactory result in 13 cases.2 cases had slight displacement.1 case had postoperative infection.Subcutaneous liquid occurred in one case and was cured by puncture and allergic response occurred.Conclusions The Nuss procedure is safe and effective.It is a new approach for asymmetric or symmetry pectus excavatum patients.Attention should be paid to prevent infection and displacement of steel plate.