详细
The purpose of the study: to compare the results of treatment of patients with pectus excavatum in different methods of thoracoplasty in children
Materials and methods: 542 patients with pectus excavatum were operated from 1996 to 2016. For the purpose of comparative estimation, the patients operated using various methods were divided into two groups. The first group included 90 children who underwent surgery using the method of Salamaa-Paltia. The second group embraced 452 patients using the Nass procedure of modified thoracoplasty. The following parameters were estimated and compared for the groups: surgery duration, length of epidural anesthesia, duration of anesthetics intake, intra- and postoperative complications, number of days spent at the hospital following the surgery.
Results: no epidural anesthesia was given to the patients from the 1st group. The children who underwent a surgery received narcotic analgesics combined with non-steroid anti-inflammatory agents prospectively. The protocol of postoperative analgesia of the 2nd group included prolonged epidural anesthesia combined with non- steroid anti- inflammatory agents. Narcotic analgesics were used only when the above mentioned agents failed to stop the pain syndrome. Thoracoscopy was performed in 9 (1.9%) of patients. Simultaneous surgeries were done in 10 (2.2%) patients. Groups I and II have significant differences as related to the time of an operation and intraoperative blood loss. The surgery duration using the Salmaa-Paltia procedure 2.7 times exceeded the length of thoracoplasty using the modified Nass procedure; intraoperative blood loss was 4 times as much.
Conclusions: the modified Nass procedure to correct the pectus excavatum is safe and effective in most cases including syndrome- based forms of the disease and enables to obtain an excellent cosmetic result. It reduces the risk of such complications as damage to the chest organs during a surgery and displacement of the plate during the postoperative period.
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