Non-Thoracoscopic Minimally Invasive Nuss Procedure For Correction Of Pectus Excavatum

Objective:To compare the consumed time of operation,blood loss during operation,extubating time after operation,postoperative length of stay in days,the average total hospitalization costs,complications and evaluation on effects for the treatment of pectus excavatum(PE) between non-thoracoscopic minimally invasive Nuss procedure, thoracoscopic minimally invasive Nuss procedure and Ravitch procedure, we study curative effect and the characteristics of the three surgical treatments of PE in order to provid reliable theoretical data to select different techniques.Methods:From February 2005 to September 2007,39 cases of PE were selected from infantile surgery of our hospital,and divided them into 3 groups according to the different way of treatment.Among them 11 patients were treated by sternal elevation method,6 patients by thoracoscopic minimally invasive Nuss procedure and 22 patients by non-thoracoscopic minimally invasive Nuss procedure.Collected data were compared and analysed.Results:①Compared to the non-thoracoscopic minimally invasive Nuss procedure,thoracoscopic minimally invasive Nuss procedure and Ravitch procedure,the non-thoracoscopic minimally invasive Nuss procedure is much better in terms of the operative time,extubating time after operation and postoperative length of stay in days(P＜0.05).As for the bleeding volume,the non-thoracoscopic minimally invasive Nuss procedure has obvious advantage than the Ravitch procedure(P＜0.05),and it is almost the same as the thoracoscopic minimally invasive Nuss procedure(P＞0.05). The cost during the non-thoracoscopic minimally invasive Nuss procedure is higher than the Ravitch procedure but much lower than the thoracoscopic minimally invasive Nuss procedure(P＜0.05).②The complications of the non-thoracoscopic minimally invasive Nuss procedure are lower than the others,but there was no significant difference in statistics(P＞0.05).③All patients of three groups were satisfied with pectus excavatum correction after operation.There were significant differences between pre-and postoperation in evaluation on effects for the treatment of PE and Funnel index(P＜0.05) but there were no significant difference among three groups after operation in statistics(P＞0.05).There is no death case in 39 patients.Conclusion:The non-thoracoscopic minimally invasive Nuss procedure is a safe surgical way with many advantages,such as mimimal invasion, fewer bleeding,shorter operation,quick recovery,less care and no difficulty.It is as safe as the thoracoscopic minimally invasive Nuss procedure.It is suitable for most cases.The Ravitch procedure may leave obvious invasions and scars after the operation,but the cost is much lower. It is supplement for minimal invasive repair.