Experience with a simple technique for pectus bar removal

被引:11
作者
Fike, Frankie B. [1 ]
Mortellaro, Vincent E. [1 ]
Iqbal, Corey W. [1 ]
Sharp, Susan W. [1 ]
Ostlie, Daniel J. [1 ]
Holcomb, George W., III [1 ]
Sharp, Ronald J. [1 ]
Snyder, Charles L. [1 ]
St Peter, Shawn D. [1 ]
机构
[1] Childrens Mercy Hosp, Dept Surg, Kansas City, MO 64108 USA
关键词
Pectus excavatum; Nuss repair; Bar removal; Technical modification; INVASIVE REPAIR; NUSS PROCEDURE; EXCAVATUM;
D O I
10.1016/j.jpedsurg.2011.07.023
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: There have been numerous reports of techniques used for pectus bar removal after correction of pectus excavatum. We use 2 operating tables positioned perpendicular to each other in a T-shaped configuration with the patients thorax circumferentially exposed so the bar is removed in 1 motion without bending the bar. In this study, we report the results of this procedure. Methods: A retrospective chart review of patients undergoing bar removal after repair of pectus excavatum at our institution from August 2000 to March 2010 was performed. Results: There were 230 patients with a mean age of 16.7 years (range, 7.8-25.3 years) at bar removal. Mean operative time for bar removal was 28.6 minutes, and average estimated blood loss (EBL) was 9.5 mL (range, 5-400 mL). One patient demonstrated significant hemorrhage from the bar tract after bar removal, which was controlled with circumferential compression wrap. Calcification was noted in 11 patients, and chondroma, in 8 patients. Wound infection after bar removal occurred in 3% of patients. No patient required the bar to be bent into a straight configuration for removal. Conclusions: Removal of pectus bars using this 2-table T-configuration technique is safe, is time efficient, and obviates the need for bending the bar. (C) 2012 Elsevier Inc. All rights reserved.
引用
收藏
页码:490 / 493
页数:4
相关论文
共 9 条
[1]   Catastrophic cardiac injuries encountered during the minimally invasive repair of pectus excavatum [J].
Bouchard, Sarah ;
Hong, Andrew R. ;
Gilchrist, Brian F. ;
Kuenzler, Keith A. .
SEMINARS IN PEDIATRIC SURGERY, 2009, 18 (02) :66-72
[2]   Experience and modification update for the minimally invasive nuss technique for pectus excavatum repair in 303 patients [J].
Croitoru, DP ;
Kelly, RE ;
Goretsky, MJ ;
Lawson, ML ;
Swoveland, B ;
Nuss, D .
JOURNAL OF PEDIATRIC SURGERY, 2002, 37 (03) :437-443
[3]   Near-fatal bleeding after transmyocardial ventricle lesion during removal of the pectus bar after the Nuss procedure [J].
Haecker, Frank-Martin ;
Berberich, Tobias ;
Mayr, Johannes ;
Gambazzi, Franco .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2009, 138 (05) :1240-1241
[4]   Life-Threatening Aortic Hemorrhage During Pectus Bar Removal [J].
Jemielity, Marek ;
Pawlak, Krystian ;
Piwkowski, Cezary ;
Dyszkiewicz, Wojciech .
ANNALS OF THORACIC SURGERY, 2011, 91 (02) :593-595
[5]   A new technique for removing the pectus bar used in the Nuss procedure [J].
Noguchi, M ;
Fujita, K .
JOURNAL OF PEDIATRIC SURGERY, 2005, 40 (04) :674-677
[6]   A 10-year review of a minimally invasive technique for the correction of pectus excavatum [J].
Nuss, D ;
Kelly, RE ;
Croitoru, DP ;
Katz, ME .
JOURNAL OF PEDIATRIC SURGERY, 1998, 33 (04) :545-552
[7]   Pectus bar removal after minimal invasive repair of pectus excavatum: Advantages of bar stabilizer anvil tool [J].
Saxena, Amulya K. .
ANNALS OF THORACIC SURGERY, 2007, 84 (04) :1364-1366
[8]   A straightforward technique for removal of the substernal bar after the Nuss operation [J].
St Peter, Shawn D. ;
Sharp, Ronald J. ;
Upadhyaya, Prashant ;
Tsao, KuoJen ;
Ostlie, Daniel J. ;
Holcomb, George W. .
JOURNAL OF PEDIATRIC SURGERY, 2007, 42 (10) :1789-1791
[9]   Initial laparoscopic appendectomy versus initial nonoperative management and interval appendectomy for perforated appendicitis with abscess: a prospective, randomized trial [J].
St. Peter, Shawn D. ;
Aguayo, Pablo ;
Fraser, Jason D. ;
Keckler, Scott J. ;
Sharp, Susan W. ;
Leys, Charles M. ;
Murphy, J. Patrick ;
Snyder, Charles L. ;
Sharp, Ronald J. ;
Andrews, Walter S. ;
Holcomb, George W., III ;
Ostlie, Daniel J. .
JOURNAL OF PEDIATRIC SURGERY, 2010, 45 (01) :236-240