微创手术矫治漏斗胸125例

目的探讨不同术式的微创手术矫治漏斗胸的特点及疗效。方法2003年3月至2008年2月，采用微创手术方法治疗漏斗胸125例。其中电视胸腔镜辅助微创手术52例；小切口直视微创手术28例；小切口不损伤胸肋骨微创手术15例；Nuss手术30例。除Nuss手术外，全部病人均选择钢板、克氏针倒T形内固定。结果手术后均恢复顺利，1例内固定钢板滑脱，术后3d重新手术固定。1例Nuss手术病人发生中量血胸。其余无重要并发症。术后胸片、CT复查胸骨位置全部恢复正常。随访2个月至2年，4例有胸壁局限性凹陷，其余病人效果满意。结论本文报告的微创手术方法创伤小，疗效好。手术年龄以3—5岁为宜。如胸骨凹陷较重，临床症状多，主张在2～3岁手术，并可选择不损伤胸骨和肋骨的微创术式。

The minimal invasive operation for pectus excavatum creport of 125 cases

Objective To summary the characteristic and therapeutic effect of different minimally invasive techniques for pectus excavatum （PE）. Methods From Mar 2003 to Feb 2008, there were 125 children with PE underwent corrective operation of PE by different minimal invasive techniques in our institution. There. were four kind of techniques were used, 1 ： thoracoscopy-assisted minimal inva.sive operation for 52 cases; 2： di- rect viewing mini-incision operation for 28 cases; 3： mini-incision with costal cartilage consecution for 15 cases and 4： Nuss procedure for 30 cases. Except the Nuss procedure, all children＇s sternal was elevated and fixed re- verse T shape internal fixation. Results All patients recovered uneventfully, but 1 patients got the steel panel dislocation who were re-fixed 3 days late, 1 patient who undergone the Nuss procedure got hemothorax. After the correct operation, the location of sternal was normal in X ray film or CT. All patients were followed-up with the period of 2 months to 2 years, local chest wall excavation was found in 4 patients. Conclusions The operation selections mentioned above have the advantages of minimal invasion and good aesthetic effect. The optimal timing of operation is the age of 3-5 years, or 2-3 years if the sternal excavation is severe.