An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting
Background: Little is known about video-assisted thoracoscopic surgery in the Nuss procedure (VATS-NUSS) and its postoperative outcomes in the resource-scarce conditions in clinical practice such as Vietnam. Available evidence in the literature was mostly reported from large institutions in develope...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2021.693562/full |
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| author | The-May Nguyen Van-Thieu Le Huu-Uoc Nguyen Huu-Uoc Nguyen Huu-Lu Pham Hong-Son Duy Phung Ngoc-Tu Vu Ngoc-Tu Vu Viet-Anh Nguyen Nam-Khanh Do Kim-Duy Vu Hoang-Long Vo Quoc-Hung Doan Quoc-Hung Doan |
| author_facet | The-May Nguyen Van-Thieu Le Huu-Uoc Nguyen Huu-Uoc Nguyen Huu-Lu Pham Hong-Son Duy Phung Ngoc-Tu Vu Ngoc-Tu Vu Viet-Anh Nguyen Nam-Khanh Do Kim-Duy Vu Hoang-Long Vo Quoc-Hung Doan Quoc-Hung Doan |
| author_sort | The-May Nguyen |
| collection | DOAJ |
| description | Background: Little is known about video-assisted thoracoscopic surgery in the Nuss procedure (VATS-NUSS) and its postoperative outcomes in the resource-scarce conditions in clinical practice such as Vietnam. Available evidence in the literature was mostly reported from large institutions in developed countries. Hence, this study was conducted to review our initial large single-center experience in the use of the VATS-NUSS for patients with pectus excavatum (PE) within 5 years.Methods: Data from 365 consecutive PE patients between January 2015 and December 2019 who were surgically treated with VATS-NUSS were retrospectively analyzed.Results: Of 365 patients, median age at operation was 15.61 ± 3.73 years (range = 5–27 years), most being child and adolescent. Three hundred nine patients (84.65%) were male. PE was commonly detected at puberty (n = 328, 89.9%). Postoperatively, early complications consisted of pneumothorax (n = 5, 1.37%), pleural bleeding/pleural fluid (n = 2, 0.55%), pleural hematoma (n = 1, 0.27%), pneumonia (n = 1, 0.27%), surgical wound infection (n = 1, 0.27%), incision fluid accumulation (n = 3, 0.82%), metal bar infection (n = 1, 0.27%), atelectasis (n = 3, 0.82%), and fever (n = 8, 2.19%). Late complications included surgical wound infection (n = 2, 0.55%), metal bar deviation (n = 5, 1.37%), metal bar allergy (n = 10, 2.74%), recurrent PE (n = 2, 0.55%), and persistent PE (n = 5, 1.37%). No deaths occurred. In 175 patients (47.95%) experiencing bar removal, mean operative time for bar removal was 34.09 ± 10.61 min, and the length of hospitalization following bar removal was 2.4 ± 1.34 days; the most frequent complication was pneumothorax (n = 19, 10.85%). One wound infection and one incision fluid accumulation happened following bar removal. Favorable midterm to long-term postoperative outcomes were achieved.Conclusions: From the beginning of the Vietnamese surgeons' experience, VATS-NUSS application obtained favorable outcomes with minimizing the occurrence of serious intraoperative and postoperative complications. Current rare evidence enables to give a real picture in the application, modification, and development of VATS-NUSS in the countries having similar resource-scarce conditions. |
| first_indexed | 2024-12-17T06:43:19Z |
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| id | doaj.art-0a6e66ad6dca4ab8a1ce28f63b13d993 |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-12-17T06:43:19Z |
| publishDate | 2021-06-01 |
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| series | Frontiers in Surgery |
| spelling | doaj.art-0a6e66ad6dca4ab8a1ce28f63b13d9932022-12-21T21:59:48ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-06-01810.3389/fsurg.2021.693562693562An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare SettingThe-May Nguyen0Van-Thieu Le1Huu-Uoc Nguyen2Huu-Uoc Nguyen3Huu-Lu Pham4Hong-Son Duy Phung5Ngoc-Tu Vu6Ngoc-Tu Vu7Viet-Anh Nguyen8Nam-Khanh Do9Kim-Duy Vu10Hoang-Long Vo11Quoc-Hung Doan12Quoc-Hung Doan13Department of Cardiovascular and Thoracic Surgery, Viet-Tiep Friendship Hospital, Hai Phong, VietnamDepartment of Cardiovascular and Thoracic Surgery, Viet-Tiep Friendship Hospital, Hai Phong, VietnamDepartment of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital, Hanoi, VietnamDepartment of Surgery, Hanoi Medical University, Hanoi, VietnamDepartment of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital, Hanoi, VietnamDepartment of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital, Hanoi, VietnamDepartment of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital, Hanoi, VietnamDepartment of Cardiovascular and Thoracic Surgery, Hanoi Medical University Hospital, Hanoi, VietnamDepartment of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital, Hanoi, VietnamInstitute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, VietnamInstitute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, VietnamInstitute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, VietnamDepartment of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital, Hanoi, VietnamDepartment of Surgery, Hanoi Medical University, Hanoi, VietnamBackground: Little is known about video-assisted thoracoscopic surgery in the Nuss procedure (VATS-NUSS) and its postoperative outcomes in the resource-scarce conditions in clinical practice such as Vietnam. Available evidence in the literature was mostly reported from large institutions in developed countries. Hence, this study was conducted to review our initial large single-center experience in the use of the VATS-NUSS for patients with pectus excavatum (PE) within 5 years.Methods: Data from 365 consecutive PE patients between January 2015 and December 2019 who were surgically treated with VATS-NUSS were retrospectively analyzed.Results: Of 365 patients, median age at operation was 15.61 ± 3.73 years (range = 5–27 years), most being child and adolescent. Three hundred nine patients (84.65%) were male. PE was commonly detected at puberty (n = 328, 89.9%). Postoperatively, early complications consisted of pneumothorax (n = 5, 1.37%), pleural bleeding/pleural fluid (n = 2, 0.55%), pleural hematoma (n = 1, 0.27%), pneumonia (n = 1, 0.27%), surgical wound infection (n = 1, 0.27%), incision fluid accumulation (n = 3, 0.82%), metal bar infection (n = 1, 0.27%), atelectasis (n = 3, 0.82%), and fever (n = 8, 2.19%). Late complications included surgical wound infection (n = 2, 0.55%), metal bar deviation (n = 5, 1.37%), metal bar allergy (n = 10, 2.74%), recurrent PE (n = 2, 0.55%), and persistent PE (n = 5, 1.37%). No deaths occurred. In 175 patients (47.95%) experiencing bar removal, mean operative time for bar removal was 34.09 ± 10.61 min, and the length of hospitalization following bar removal was 2.4 ± 1.34 days; the most frequent complication was pneumothorax (n = 19, 10.85%). One wound infection and one incision fluid accumulation happened following bar removal. Favorable midterm to long-term postoperative outcomes were achieved.Conclusions: From the beginning of the Vietnamese surgeons' experience, VATS-NUSS application obtained favorable outcomes with minimizing the occurrence of serious intraoperative and postoperative complications. Current rare evidence enables to give a real picture in the application, modification, and development of VATS-NUSS in the countries having similar resource-scarce conditions.https://www.frontiersin.org/articles/10.3389/fsurg.2021.693562/fullVATSNusscongenital pectus excavatumcomplicationsthoracoscopic surgery |
| spellingShingle | The-May Nguyen Van-Thieu Le Huu-Uoc Nguyen Huu-Uoc Nguyen Huu-Lu Pham Hong-Son Duy Phung Ngoc-Tu Vu Ngoc-Tu Vu Viet-Anh Nguyen Nam-Khanh Do Kim-Duy Vu Hoang-Long Vo Quoc-Hung Doan Quoc-Hung Doan An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting Frontiers in Surgery VATS Nuss congenital pectus excavatum complications thoracoscopic surgery |
| title | An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting |
| title_full | An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting |
| title_fullStr | An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting |
| title_full_unstemmed | An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting |
| title_short | An Initial 5-Year Single-Center Experience of 365 Patients Undergoing the Video-Assisted Thoracoscopic Surgery for Nuss Procedure for Pectus Excavatum in Resource-Scare Setting |
| title_sort | initial 5 year single center experience of 365 patients undergoing the video assisted thoracoscopic surgery for nuss procedure for pectus excavatum in resource scare setting |
| topic | VATS Nuss congenital pectus excavatum complications thoracoscopic surgery |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2021.693562/full |
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