Non-thoracoscopic Nuss procedure for treating pectus excavatum in children.

Objective To review our experience of the Nuss procedure for treating pectus excavatum in children without thoracoscope.Methods All the operations were performed under general anesthesia with endotracheal intubation.A transeverse incision was made in each lateral chest wall.A steel bar was passed under the sternum from the right thoracic cavity without thoracoscope.Then the bar was turned over to raise the sternum to the normal position.The bar was fixed with bilateral costal bones by using two stabilizing bars.The bar was removed 2 years after the procedure.Results The procedure was completed smoothly in all the 22 patients.The operating time was 30～55 min(mean,45 min).The intraoperative blood loss was 5～10 ml(mean,8 ml).Complications included postoperative pneumothorax in 2 patients,subcutaneous emphysema in 4 patients,bar displacement in 1 patient,and lateral stabilizer dislocation in 1 patient.The length of postoperative hospital stay was 6～9 d(mean,7 d).Excellent efficacy assessment after 20 cases,good in 2 cases and poor in 0 case.The duration of follow-up was 4～18 months(mean,10 months).Conclusion The non-thoracoscopic Nuss procedure has many advantages such as small and masked incision,short operation time,little blood loss,quick recovery and little trauma.It is a safe and reliable procedure.