First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review
Journal Title: Iranian Journal of Medical Sciences - Year 2018, Vol 43, Issue 5
Abstract
Pectus excavatum is the most common congenital deformity of the chest wall. The most frequently used techniques include Ravitch (costochondral resection) and Nuss (minimally invasive pectus repair of pectus excavatum [MIRPE]). The Nuss technique includes using temporary metallic bars without costochondral resection to correct the chest wall deformity. Modified MIRPE can be learned easily and performed safely with few complications. There are no reports of successful MIRPE in Iran, although the Ravitch technique is well known. In the present study, we report the first Iranian experience with the modified Nuss procedure in 5 patients with pectus excavatum (age range=13–48 y). All the patients suffered from low self-esteem, and one of them complained of low exercise capacity and occasional chest pain. With single-lung ventilation and sternal elevation, an introducer was entered into the right thoracic cavity and retrosternal tunneling was performed under thoracoscopic vision. The introducer was passed to the left thoracic cavity and exited on the left thoracic wall. A titanium plate bar was implanted and fixed with stabilizers. There were no cases of mortality, and all the patients were discharged in good conditions within 2 weeks. Postoperative complications consisted of 1 case of pneumothorax and 2 cases of fixed bar protrusion. The present case series indicated that a skilled thoracoscopic surgeon is able to do the Nuss procedure in Iranian patients with symmetrical pectus excavatum with few complications. However, mixed or redo cases require more expertise.
Authors and Affiliations
Hamidreza Davari, Mohammad Bagher Rahim, Reza Ershadi, Shahab Rafieian, Parviz Mardani, Mohammad Rahim Vakili, Ahmad Shirinzadeh
Keywords
Related Articles
- EP ID EP381226
- DOI -
- Views 87
- Downloads 0
Segmental Duplications as a Complement Strategy to Short Tandem Repeats in the Prenatal Diagnosis of Down Syndrome
Background: Quantitative fluorescence-polymerase chain reaction (QF-PCR) is an inexpensive and accurate method for the prenatal diagnosis of aneuploidies that applies short tandem repeats (STRs) as a chromosome-specific...
Antiproliferative Effects of Pancratium Maritimum Extracts on Normal and Cancerous Cells
Background: Plants are an important natural source of compounds used in cancer therapy. Pancratium maritimum contains potential anti-cancer agents such as alkaloids. In this study, we investigated the anti-proliferative...
Interleukin-10 and Interferon-γ Levels in Patients with Cutaneous Leishmaniasis Treated with Cryotherapy
Pentavalent antimonials, as the 1st choice for the treatment of cutaneous leishmaniasis (CL), have various side effects. Also, there are some reports of drug resistance. Due to its safety, cryotherapy can be a good alter...
Changes in the Hypothalamic-Pituitary-Gonadal Axis in Adult Male Rats Poisoned with Proteus and Biscaya Insecticides
Background: Insecticides may have negative effects on reproductive organs. Given the interaction between leptin and the hypothalamic-pituitary-gonadal (HPG) axis, we sought to investigate the changes in leptin and the HP...
Inguinal Bladder Hernia: Use of Virtual Computed Tomographic Cystography
Inguinal bladder hernia (IBH) was first described in 1951 as scrotal cystocele. It is an uncommon clinical entity that occurs in approximately 1-4% of inguinal hernias.1 Despite numerous studies, IBH remains a challenge...