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The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique
OBJECTIVES: To compare bar displacement and complication rates in three retrospective series of patients operated on by the same surgical team. METHOD: A retrospective medical chart analysis of the three patient series was performed. In the first series, the original, unmodified Nuss technique was p...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180147/ https://www.ncbi.nlm.nih.gov/pubmed/22012046 http://dx.doi.org/10.1590/S1807-59322011001000012 |
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author | Tedde, Miguel Lia de Campos, José Ribas Milanez Das-Neves-Pereira, João-Carlos Abrão, Fernando Conrado Jatene, Fábio Biscegli |
author_facet | Tedde, Miguel Lia de Campos, José Ribas Milanez Das-Neves-Pereira, João-Carlos Abrão, Fernando Conrado Jatene, Fábio Biscegli |
author_sort | Tedde, Miguel Lia |
collection | PubMed |
description | OBJECTIVES: To compare bar displacement and complication rates in three retrospective series of patients operated on by the same surgical team. METHOD: A retrospective medical chart analysis of the three patient series was performed. In the first series, the original, unmodified Nuss technique was performed. In the second, we used the “third point fixation” technique, and in the last series, the correction was performed with modifications to the stabilizer and stabilizer position. RESULTS: There were no deaths in any of the series. Minor complications occurred in six (4.9%) patients: pneumothorax with spontaneous resolution (2), suture site infection (2), and bar displacement without the reoperation need (2). Major complications were observed in eight (6.5%) patients: pleural effusion requiring drainage (1), foreign body reaction to the bar (1), pneumonia and shock septic (1), cardiac perforation (1), skin erosion/seroma (1), and displacement that necessitated a second operation to remove the bar within the 30 days of implantation (3). All major complications occurred in the first and second series. CONCLUSION: The elimination of fixation wires, the use of shorter bars and redesigned stabilizers placed in a more medial position results in a better outcome for pectus excavatum patients treated with the Nuss technique. With bar displacement and instability no longer significant postoperative risks, the Nuss technique should be considered among the available options for the surgical correction of pectus excavatum in pediatric patients. |
format | Online Article Text |
id | pubmed-3180147 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo |
record_format | MEDLINE/PubMed |
spelling | pubmed-31801472011-10-01 The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique Tedde, Miguel Lia de Campos, José Ribas Milanez Das-Neves-Pereira, João-Carlos Abrão, Fernando Conrado Jatene, Fábio Biscegli Clinics (Sao Paulo) Clinical Science OBJECTIVES: To compare bar displacement and complication rates in three retrospective series of patients operated on by the same surgical team. METHOD: A retrospective medical chart analysis of the three patient series was performed. In the first series, the original, unmodified Nuss technique was performed. In the second, we used the “third point fixation” technique, and in the last series, the correction was performed with modifications to the stabilizer and stabilizer position. RESULTS: There were no deaths in any of the series. Minor complications occurred in six (4.9%) patients: pneumothorax with spontaneous resolution (2), suture site infection (2), and bar displacement without the reoperation need (2). Major complications were observed in eight (6.5%) patients: pleural effusion requiring drainage (1), foreign body reaction to the bar (1), pneumonia and shock septic (1), cardiac perforation (1), skin erosion/seroma (1), and displacement that necessitated a second operation to remove the bar within the 30 days of implantation (3). All major complications occurred in the first and second series. CONCLUSION: The elimination of fixation wires, the use of shorter bars and redesigned stabilizers placed in a more medial position results in a better outcome for pectus excavatum patients treated with the Nuss technique. With bar displacement and instability no longer significant postoperative risks, the Nuss technique should be considered among the available options for the surgical correction of pectus excavatum in pediatric patients. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2011-10 /pmc/articles/PMC3180147/ /pubmed/22012046 http://dx.doi.org/10.1590/S1807-59322011001000012 Text en Copyright © 2011 Hospital das Clínicas da FMUSP http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Science Tedde, Miguel Lia de Campos, José Ribas Milanez Das-Neves-Pereira, João-Carlos Abrão, Fernando Conrado Jatene, Fábio Biscegli The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique |
title | The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique |
title_full | The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique |
title_fullStr | The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique |
title_full_unstemmed | The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique |
title_short | The search for stability: bar displacement in three series of pectus excavatum patients treated with the Nuss technique |
title_sort | search for stability: bar displacement in three series of pectus excavatum patients treated with the nuss technique |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180147/ https://www.ncbi.nlm.nih.gov/pubmed/22012046 http://dx.doi.org/10.1590/S1807-59322011001000012 |
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