Comparative Study On The Clinical Effect Of A New Type Of Minimally Invasive Pectus Excavatum

BackgroundPectus excavatum(PE)is the most common deformity of the chest and the incidence rate is about 0.1-0.3%.The most effective method is surgical therapy for PE.Nuss introduced the minimally invasive treatment of pectus excavatum in 1998.In recent years,surgical treatment has been improved which gives a better cosmetic result and less trauma.Nuss procedure gradually replace open repair of pectus excavatum.On the experience of Nuss procedure,We have improved the surgical instruments and technique and patented it.The first new type of surgical treatment was launched in November 2010.At present,there is no comparison between this new technique and Nuss procedure.ObjectiveThe aim of this study was to investigate the safety and effectiveness by compared the clinical data of two technique under different age groups.To provide reference for clinical treatment of pectus excavatum,this study research the differences between two kinds of surgical treatment in changes of Haller index,Perioperative condition,complications and surgical instruments.MethodologyThe experimental group had 219 patients who underwent new minimally invasive procedure and had taken off the bar between November 2010 and November 2016 in our Hospital.All the patients were divided into 2 groups according to age.Group A: Less than 12 years(n=147).The operation scheme had single incision and 1 bar(Uniportal Procedure for the Correction of Pectus Excavatum).Group B: Over 12 years old(n=72).The operation need 1 or 2 bars.235 cases of patients underwent Nuss procedure from February 2008 to June 2012 were selected and grouped in the same method as control group.With a retrospective comparative analysis,this study research the differences between two kinds of surgical treatment in changes of Haller index,surgical instruments,Perioperative condition(including operation time,intraoperative blood loss,postoperative hospital stay),complications and Operation effect.ResultsAll the cases in experimental group and control group were operated successfully,and the Haller index was significantly improved after operation.No matter less than 12 years old age group and above 12 years old group: the operation time of the experimental group was significantly less than the control group,and the difference was statistically significant.There was no significant difference in the the data of bleeding,Hospitalization days,incidence of postoperative complications and efficacy evaluation.ConclusionsNo matter new type of minimally invasive procedure and Nuss procedure,postoperative Haller index is significantly improved and both of them could be effective in treatment of different age groups of patients with pectus excavatum.Compared with Nuss operation,new type of minimally invasive procedure is no significant difference in the safety and effectiveness,the operation time is more shorter and more convenient and less trauma.