The Comparative Study Of Clinical Effects With The Nuss Procedure For Pectus Excavatum Of Different Age Groups

Part OneThe Contrast of Perioperative period and Clinical effects with theNuss Procedure for Pectus Excavatum of different age groupsObjective:A retrospective study was carried out for Pectus Excavatum of differentage groups with the Nuss procedure.To explore the surgical school-age period forPectus Excavatum from the contrast of Perioperative period and Clinical effects.Methods: Collect172patients’ clinical date with pectus excavatum underwent Nussprocedure(all patients are the first line of the thoracic correction surgery),divided them into three age groups:A：from3years to6years(n=95），B：from6years to12years(n=51）， C： older than12years(n=26).T he operative time,bloodloss,postoperative bad time,hospital stay time, postoperative pain and postoperativecomplication were targeted for comparative analysis.Assess the clinical efficacy of thethree groups of patients under the Nuss evaluation standard.And make comparativeanalysis among the three groups.Results:172cases were successfully operated.A and B were not different in theoperative time(P>0.05),but group C significantly prolonged compared to A andB(P<0.01).Group A significantly reduced in blood loss than B and C(P<0.01),B and Cwere different too（P<0.05）.With increasing age, postoperative bad time increasedgradually,and with higher pain scores in Wong-baker too,the three groups weredifferent significantly(P<0.01).The postoperative complication in proper order of thegroup A,B,C were11.6%，19.6%，30.8%，group A and C were different(P<0.05).Thefineness in proper order of the group A,B,C were97.9%，96.1%，92.3%，and theywere not different significantly(P>0.05).Conclusions:1.Patients with pectus excavatum of different age had received a highdegree of satisfaction.2.The younger,the operation can be easier, the postoperative pain can be lighter,andthe postoperative complication were fewer.3.The age of Nuss procedure for pectus excavatum can be advanced, and it was safe. Part TwoThe observation of the impact on the patients’ life with the NussProcedure for Pectus Excavatum and mid-term outcome of differentage groupsObjective:Assess the impact on the patients’ life with the Nuss Procedure for PectusExcavatum of different age groups and mid-term outcome.Methods:The questionnaire uses a modified version of the M-SSQ.Since some patients were not old enough to express themselves,we need analyze the relevance ofthe questionnaire results of the assessment between group C’ patients and their parentsfirst,observed whether the results of their parents’ questionnaire can be used as thebasis of patients’ quality of life before and after surgery. Then selected the85patients’parents who had removed the orthopedic steel for further questionnaire from172patients of part one,the quantity in proper order of the group A,B,C were45,25,15.Statistics the recurrence rate between the three groups.Results:The score of the patients of group C and their parents’ questionnaire wereconsistent(Spearman correlation coefficient was0.88，P<0.05).The three groups’questionnaire average total score was53.93±7.03、50.00±7.12、48.50±4.89,UseKruskal-Wallis Rank sum test to calculate the score of the parents’ questionnaire ofthe three groups,they were not statistically significant(P>0.05).The proportion of thedeformity’s affect(question3) among A,B.C were22.2%,68%,86.7%,A and B,C werestatistically significant(P<0.01).The recurrence rate in proper order of the groupA,B,C were4.4%，4.0%,6.7%，and they were not statistically significant(P>0.05).Conclusions:1.The results of parents’ questionnaire can be used as the basis ofpatients’ quality of life before and after surgery.2.All the patients of different age with the steel plate removed can get a better qualityof life;The surgery can reduce the deformity of children with low age group,and it didnot increase the recurrence rate;3.It was safe and feasible with the Nuss Procedure for Pectus Excavatum at3-6years.