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Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum

Nuss surgery is effective in correcting pectus excavatum (PE), with a recurrence rate of 1.2–27%. Re-do surgery is successful but still has a 6% failure rate. Patients with obstructive sleep apnea (OSA) experience repetitive PE-associated sternal depression during sleep. As the prevalence of OSA amo...

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Autores principales: Huang, Yi-Chih, Cheng, Yeung-Leung, Su, Wen-Lin, Lan, Chou-Chin, Wu, Yao-Kuang, Yang, Mei-Chen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651565/
https://www.ncbi.nlm.nih.gov/pubmed/36367884
http://dx.doi.org/10.1371/journal.pone.0277494
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author Huang, Yi-Chih
Cheng, Yeung-Leung
Su, Wen-Lin
Lan, Chou-Chin
Wu, Yao-Kuang
Yang, Mei-Chen
author_facet Huang, Yi-Chih
Cheng, Yeung-Leung
Su, Wen-Lin
Lan, Chou-Chin
Wu, Yao-Kuang
Yang, Mei-Chen
author_sort Huang, Yi-Chih
collection PubMed
description Nuss surgery is effective in correcting pectus excavatum (PE), with a recurrence rate of 1.2–27%. Re-do surgery is successful but still has a 6% failure rate. Patients with obstructive sleep apnea (OSA) experience repetitive PE-associated sternal depression during sleep. As the prevalence of OSA among PE patients is higher than the average, co-existing OSA in PE patients might negatively affect the efficacy of Nuss surgery. This study aimed to evaluate the impact of co-existing OSA on Nuss surgery in patients with PE. In total, 20 adult patients with PE only and 9 patients with PE and OSA were analyzed. Polysomnography was performed before Nuss surgery to evaluate OSA. Sternovertebral distance (SVD) and radiographic Haller index (RHI) were recorded before surgery and at 3, 6, and 24 months postoperatively. The results showed that percentage changes in SVD in patients with PE only at 3, 6, and 24 months postoperatively were significantly increased compared with those in the patients with PE and OSA (31.1% vs. 14.1% at 3 months; 37.5% vs. 21.4% at 6 months; 42.5% vs. 19.2% at 24 months). Meanwhile, percentage changes in RHI were significantly lower in patients with PE alone than in the patients with PE and OSA (-22.9% vs. -9.3% at 3 months; -27.9% vs. -18.7% at 6 months; -30.6% vs. -16.7% at 24 months). This study showed that co-existing OSA might reduce the efficacy of Nuss surgery for patients with PE. We recommend that patients with PE should be evaluated and treated for OSA before surgery to prevent surgical failure after bar removal.
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spelling pubmed-96515652022-11-15 Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum Huang, Yi-Chih Cheng, Yeung-Leung Su, Wen-Lin Lan, Chou-Chin Wu, Yao-Kuang Yang, Mei-Chen PLoS One Research Article Nuss surgery is effective in correcting pectus excavatum (PE), with a recurrence rate of 1.2–27%. Re-do surgery is successful but still has a 6% failure rate. Patients with obstructive sleep apnea (OSA) experience repetitive PE-associated sternal depression during sleep. As the prevalence of OSA among PE patients is higher than the average, co-existing OSA in PE patients might negatively affect the efficacy of Nuss surgery. This study aimed to evaluate the impact of co-existing OSA on Nuss surgery in patients with PE. In total, 20 adult patients with PE only and 9 patients with PE and OSA were analyzed. Polysomnography was performed before Nuss surgery to evaluate OSA. Sternovertebral distance (SVD) and radiographic Haller index (RHI) were recorded before surgery and at 3, 6, and 24 months postoperatively. The results showed that percentage changes in SVD in patients with PE only at 3, 6, and 24 months postoperatively were significantly increased compared with those in the patients with PE and OSA (31.1% vs. 14.1% at 3 months; 37.5% vs. 21.4% at 6 months; 42.5% vs. 19.2% at 24 months). Meanwhile, percentage changes in RHI were significantly lower in patients with PE alone than in the patients with PE and OSA (-22.9% vs. -9.3% at 3 months; -27.9% vs. -18.7% at 6 months; -30.6% vs. -16.7% at 24 months). This study showed that co-existing OSA might reduce the efficacy of Nuss surgery for patients with PE. We recommend that patients with PE should be evaluated and treated for OSA before surgery to prevent surgical failure after bar removal. Public Library of Science 2022-11-11 /pmc/articles/PMC9651565/ /pubmed/36367884 http://dx.doi.org/10.1371/journal.pone.0277494 Text en © 2022 Huang et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Huang, Yi-Chih
Cheng, Yeung-Leung
Su, Wen-Lin
Lan, Chou-Chin
Wu, Yao-Kuang
Yang, Mei-Chen
Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum
title Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum
title_full Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum
title_fullStr Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum
title_full_unstemmed Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum
title_short Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum
title_sort co-existing obstructive sleep apnea reduces nuss surgery efficacy in pectus excavatum
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651565/
https://www.ncbi.nlm.nih.gov/pubmed/36367884
http://dx.doi.org/10.1371/journal.pone.0277494
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