Factors Determining the Complications in Nuss Procedure

Overview

Journal Turk Gogus Kalp Damar Cerrahisi Derg

Specialty Cardiology & Vascular Diseases

Date 2020 Feb 22

PMID 32082805

Authors

Ozgur Katrancioglu

Yucel Akkas

Tuba Sahinoglu

Ekber Sahin

Sule Karadayi

Nurkay Katrancioglu

Affiliations

Soon will be listed here.

Abstract

Background: This study aims to share our experiences in complications developing in patients who underwent Nuss procedure and the management of these complications.

Methods: In the study, files of 59 patients (50 males, 9 females; mean age 17.6±5.1 years; range, 2.5 to 33 years) who were applied Nuss procedure for pectus excavatum in our clinic between July 2007 and May 2016 were retrospectively assessed. Patients" age, gender, surgical method-complications and hospitalization durations were recorded. Fisher"s chisquare test and logistic regression analysis were used for data evaluation.

Results: Nuss procedure was performed in all patients without severe complications such as death, organ injury or massive hemorrhage. The most frequently observed postoperative earlyperiod complication was minimal pneumothorax (n=16, 27.1%), while bar dislocation was most frequently observed in the lateperiod (n=5, 8.3%).

Conclusion: Being male and/or over 23 years of age were determined as risk factors for complication development after Nuss procedure. Still, being a minimally invasive and manageable approach with its success in correcting the deformity, short operation duration, and low complication rates, Nuss procedure can be safely performed in selected patients.

References

Krasopoulos G, Dusmet M, Ladas G, Goldstraw P . Nuss procedure improves the quality of life in young male adults with pectus excavatum deformity. Eur J Cardiothorac Surg. 2005; 29(1):1-5. DOI: 10.1016/j.ejcts.2005.09.018. View

Hu T, Li Y, Liu W, Wu X, Feng J . Surgical treatment of pectus excavatum: 30 years 398 patients of experiences. J Pediatr Surg. 2008; 43(7):1270-4. DOI: 10.1016/j.jpedsurg.2008.02.075. View

Nuss D . Minimally invasive surgical repair of pectus excavatum. Semin Pediatr Surg. 2008; 17(3):209-17. DOI: 10.1053/j.sempedsurg.2008.03.003. View

Protopapas A, Athanasiou T . Peri-operative data on the Nuss procedure in children with pectus excavatum: independent survey of the first 20 years' data. J Cardiothorac Surg. 2008; 3:40. PMC: 2474598. DOI: 10.1186/1749-8090-3-40. View

HALLER Jr J, Kramer S, Lietman S . Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report. J Pediatr Surg. 1987; 22(10):904-6. DOI: 10.1016/s0022-3468(87)80585-7. View

Obert L, Munyon R, Choe A, Rubenstein J, Azizkhan R . Rare late complication of the Nuss procedure: a case report. J Pediatr Surg. 2012; 47(3):593-7. DOI: 10.1016/j.jpedsurg.2011.12.002. View

Hoel T, Rein K, Svennevig J . A life-threatening complication of the Nuss procedure for pectus excavatum. Ann Thorac Surg. 2005; 81(1):370-2. DOI: 10.1016/j.athoracsur.2004.09.008. View

Leonhardt J, Kubler J, Feiter J, Ure B, Petersen C . Complications of the minimally invasive repair of pectus excavatum. J Pediatr Surg. 2005; 40(11):e7-9. DOI: 10.1016/j.jpedsurg.2005.07.033. View

Donders H, Geelen J . Thoracic outlet syndrome after corrective surgery for pectus excavatum. Neth J Surg. 1988; 40(1):20-2. View

10.

Pilegaard H, Licht P . Early results following the Nuss operation for pectus excavatum--a single-institution experience of 383 patients. Interact Cardiovasc Thorac Surg. 2007; 7(1):54-7. DOI: 10.1510/icvts.2007.160937. View

11.

Cheng Y, Lee S, Huang T, Wu C . Efficacy and safety of modified bilateral thoracoscopy-assisted Nuss procedure in adult patients with pectus excavatum. Eur J Cardiothorac Surg. 2008; 34(5):1057-61. DOI: 10.1016/j.ejcts.2008.07.068. View

12.

Castellani C, Schalamon J, Saxena A, Hoellwarth M . Early complications of the Nuss procedure for pectus excavatum: a prospective study. Pediatr Surg Int. 2008; 24(6):659-66. DOI: 10.1007/s00383-008-2106-z. View

13.

Hebra A, Kelly R, Ferro M, Yuksel M, Campos J, Nuss D . Life-threatening complications and mortality of minimally invasive pectus surgery. J Pediatr Surg. 2017; 53(4):728-732. DOI: 10.1016/j.jpedsurg.2017.07.020. View

14.

Nuss D, Kelly Jr R, Croitoru D, Katz M . A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg. 1998; 33(4):545-52. DOI: 10.1016/s0022-3468(98)90314-1. View