Abstract:
Nuss repair of funnel chests is used increasingly, but has a high bar dislocation rate. The authors intended
to reduce this by technical modifications of the original Nuss technique.
Methods: In 350 patients from 6 to 17 years of age (mean, 12.4 ± 3.8) were operated by Nuss procedure
at the Filatov Children’s Hospital in Moscow for the last 10 years. 37% of patients had Sindromalny pathology.
Operation technique: The bars were placed from left to right with use of specially metal conductor; introduced of the T-shaped titanic plate; fixing of both ends of a plate. Plate was removed in 4 years after surgery.
Results. Duration of operation averaged 38±7 minutes. Terms of hospitalization averaged 8,5±2 days.
Thoracoscopy was used only at 8 (2,2%) patients. From them 4 patients were previous operated by Paltia plate
repair, at 3(0,8%) patients – after sternotomiya for correction of CHA and 1 patient after a pulmonectomiya.
Simultanny operations were done in 4 (1,1%) patients: Thoracoscopycal ductus arteriosus repair - 2 patients,
Thoracoscopycal resection of a lung - 2 patients.
Complications: pheumothorax – 2(0,5%), gemathorax– 2(0,5%), plate shift – 1(0,2%) patient. One patient
observed hyper correction of the chest. In 98% we had the excellent cosmetic and functional result. Residual
deformation was observed - 7 (2%) patients. All patients were reoperated with excellent results.
Conclusion. The modified technique more safely and has reduced the incidence of bar dislocation.
