COMPARATIVE ESTIMATION OF TREATMENT RESULTS IN DIFFERENT METHODS OF THORACOPLASTY IN CHILDREN WITH PECTUS EXCAVATUM

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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.

作者简介

A. Razumovsky

N.I. Pirogov Russian National Research Medical University;

Email: fake@neicon.ru

Доктор медицинских наук, проф., зав. кафедрой детской хирургии РНИМУ им. Н.  И. Пирогова. Заведующий отделением торакальной хирургии ДГКБ № 13 им. Н. Ф. Филатова

俄罗斯联邦

A. Alkhasov

N.F. Filatov Children’s Municipal Clinical Hospital No. 13

Email: fake@neicon.ru
Доктор медицинских наук, проф., врач – торакальный хирург, ДГКБ № 13 俄罗斯联邦

Z. Mitupov

N.F. Filatov Children’s Municipal Clinical Hospital No. 13

Email: fake@neicon.ru

Доктор медицинских наук, доц., врач – торакальный хирург, ДГКБ № 13 им. Н. Ф. Филатова

俄罗斯联邦

D. Dallakyan

"Sourb Astvatsamayr" mc

编辑信件的主要联系方式.
Email: ddallakyan@yahoo.com
Yerevan 亚美尼亚

M. Savelieva

N.I. Pirogov Russian National Research Medical University;

Email: fake@neicon.ru
Аспирант кафедры детской хирургии РНИМУ им. Н. И. Пирогова 俄罗斯联邦

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