[Minimally invasive approach of Nuss for the correction of pectus excavatum]. / Abordaje mínimamente invasivo de Nuss para la corrección del pectus excavatum.

Since December 1999 to November 2003, we treated 68 patients with pectus excavatum using the Nuss minimally invasive procedure. Their ages were between 6 and 24 years old, with a mean of 12 years. Average Haller index was 4.1. Lateral stabilisers were used in all the cases, in 28% of them, two stabilisers were used. Mean operative time was 70 minutes (range 40 to 120). A thoracic epidural catheter was used for postoperative analgesia in 87% of the cases, with a mean duration of 3 days. The most frequent early complication was residual pneumothorax, which resolved spontaneously in 24% of the cases. The average hospital stay was 5.7 days. 93% of patients had excellent, very good or good results, in 5% of the cases the results were fair, and 2% had poor results due to thoracic asimetry and/or sternal rotation. The Nuss minimally invasive procedure is a useful method for treatment of pectus excavatum's patients.

Abordaje mínimamente invasivo de Nuss para la corrección del pectus excavatum / Evidence-based medicine in spanish pediatric surgery reports

Desde Diciembre de 1999 hasta Noviembre de 2003 tratamos quirúrgicamente a 68 pacientes con pectus excavatum utilizando la técnica mínimamente invasiva de Nuss. El rango de edades al momento de cirugía fue de 6 a 24 años, la media de edad 12 años. La media para el índice de Haller en esta población fue de 4,1. Se colocaron estabilizadores laterales en todos los pacientes, en el 28% se colocaron en ambos lados. Se colocó catéter epidural para el manejo analgésico postoperatorio en el 87% de los casos, con duración media de 3 días. El tiempo operatorio promedio fue de 70 min (rango 40- 120 min). La complicación temprana más frecuente fue la presencia de neumotórax de resolución espontánea en el 24%. El tiempo de internación medio fue de 5,7 días. En 93% de los pacientes, los resultados fueron muy buenos y buenos; 5% regulares y malos en 2% debido a la presencia de asimetría torácica y/o rotación esternal. La técnica mínimamente invasiva de Nuss resulta una útil herramienta para el tratamiento de los pacientes con pectus excavatum (AU)

Since December 1999 to November 2003, we treated 68 patients with pectus excavatum using the Nuss minimally invasive procedure. Their ages were between 6 and 24 years old, with a mean of 12 years. Average Haller index was 4,1. Lateral stabilisers were used in all the cases, in 28% of them, two stabilisers were used. Mean operative time was 70 minutes (range 40 to 120). A thoracic epidural catheter was used for postoperative analgesia in 87% of the cases, with a mean duration of 3 days. The most frequent early complication was residual pneumothorax, which resolved spontaneously in 24% of the cases. The average hospital stay was 5,7 days. 93% of patients had excellent, very good or good results, in 5% ot the cases the results were fair, and 2% had poor results due to thoracic asimetry and/or sternal rotation. The Nuss minimally invasive procedure is a useful method for treatment of pectus excavatum´s patients (AU)