First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review
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 costoch...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Shiraz University of Medical Sciences
2018-09-01
|
| Series: | Iranian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://ijms.sums.ac.ir/index.php/IJMS/article/view/4158 |
| _version_ | 1819074259064979456 |
|---|---|
| author | Hamidreza Davari Mohammad Bagher Rahim Reza Ershadi Shahab Rafieian Parviz Mardani Mohammad Rahim Vakili Ahmad Shirinzadeh |
| author_facet | Hamidreza Davari Mohammad Bagher Rahim Reza Ershadi Shahab Rafieian Parviz Mardani Mohammad Rahim Vakili Ahmad Shirinzadeh |
| author_sort | Hamidreza Davari |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T18:06:40Z |
| format | Article |
| id | doaj.art-87b5477baa01463b9afd255b1766d956 |
| institution | Directory Open Access Journal |
| issn | 0253-0716 1735-3688 |
| language | English |
| last_indexed | 2024-12-21T18:06:40Z |
| publishDate | 2018-09-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Medical Sciences |
| spelling | doaj.art-87b5477baa01463b9afd255b1766d9562022-12-21T18:54:55ZengShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-07161735-36882018-09-01435554559First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature ReviewHamidreza Davari0Mohammad Bagher Rahim1Reza Ershadi2Shahab Rafieian3Parviz Mardani4Mohammad Rahim Vakili5Ahmad Shirinzadeh6General Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran IranGeneral Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran IranGeneral Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran IranGeneral Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran IranGeneral Thoracic Surgeon, General Surgery Ward, Shiraz University of Medical Sciences, Shiraz, IranGeneral Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran IranGeneral Thoracic Surgeon, General Thoracic Surgery Ward, Tehran University of Medical Sciences, Tehran IranPectus 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.http://ijms.sums.ac.ir/index.php/IJMS/article/view/4158Funnel chestMinimally invasive surgical proceduresIran |
| spellingShingle | Hamidreza Davari Mohammad Bagher Rahim Reza Ershadi Shahab Rafieian Parviz Mardani Mohammad Rahim Vakili Ahmad Shirinzadeh First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review Iranian Journal of Medical Sciences Funnel chest Minimally invasive surgical procedures Iran |
| title | First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review |
| title_full | First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review |
| title_fullStr | First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review |
| title_full_unstemmed | First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review |
| title_short | First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review |
| title_sort | first iranian experience of the minimally invasive nuss procedure for pectus excavatum repair a case series and literature review |
| topic | Funnel chest Minimally invasive surgical procedures Iran |
| url | http://ijms.sums.ac.ir/index.php/IJMS/article/view/4158 |
| work_keys_str_mv | AT hamidrezadavari firstiranianexperienceoftheminimallyinvasivenussprocedureforpectusexcavatumrepairacaseseriesandliteraturereview AT mohammadbagherrahim firstiranianexperienceoftheminimallyinvasivenussprocedureforpectusexcavatumrepairacaseseriesandliteraturereview AT rezaershadi firstiranianexperienceoftheminimallyinvasivenussprocedureforpectusexcavatumrepairacaseseriesandliteraturereview AT shahabrafieian firstiranianexperienceoftheminimallyinvasivenussprocedureforpectusexcavatumrepairacaseseriesandliteraturereview AT parvizmardani firstiranianexperienceoftheminimallyinvasivenussprocedureforpectusexcavatumrepairacaseseriesandliteraturereview AT mohammadrahimvakili firstiranianexperienceoftheminimallyinvasivenussprocedureforpectusexcavatumrepairacaseseriesandliteraturereview AT ahmadshirinzadeh firstiranianexperienceoftheminimallyinvasivenussprocedureforpectusexcavatumrepairacaseseriesandliteraturereview |