Objective

Pectus Excavatum’s (PE) surgical treatment should be patient specific. In this article, we aimed to compare parallel and cross bar variations of the Nuss method and analyze if there is any difference in results.

Methods

In this study, a total of 891 patients treated with the Nuss method between August 2005 and February 2018 were considered. These were retrieved from a prospectively recorded PE database. Of these, 276 double-bar patients were included in the study. Patients with parallel bars (225 cases) and patients with crossed bars (51 cases) were compared in terms of age, gender, symmetry, family history, additional anomalies, mean operation time, postoperative hospital stay (days) and hospital readmission rate.

Results

The mean age was measured at 20.7 for parallel bar patients and 20.1 for crossed bars patients. There was no statistically significant difference in terms of age, gender, and mean operation time between two groups. On the other hand, statistical significance was found between two groups when analyzing the deformities’ symmetry, patients’ family history and additional anomalies. The statistically significant difference of postoperative hospital stay between two groups is clinically negligible. Postoperative hospital readmission rates due to serous pleural effusion were found to be significantly increased in patients with crossed bars (p < 0.001).

Conclusion

While pleural effusion requiring readmission was statistically more frequent in cross bars, in centers where thoracentesis can be managed, Nuss method can still be applied safely, even in cases with difficult, complex deformities.

Level of evidence

III. Treatment study.

中文翻译：

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由于浆液性胸腔积液，胸横杆增加了再入院率

客观的

漏斗胸 (PE) 手术治疗应针对患者。在本文中，我们旨在比较 Nuss 方法的平行和交叉杆变体，并分析结果是否存在差异。

方法

在这项研究中，总共考虑了 2005 年 8 月至 2018 年 2 月期间接受 Nuss 方法治疗的 891 名患者。这些是从前瞻性记录的 PE 数据库中检索到的。其中，276 名双杠患者被纳入研究。比较双杠患者（225例）和横杠患者（51例）的年龄、性别、对称性、家族史、额外异常、平均手术时间、术后住院天数和再入院率。

结果

双杠患者的平均年龄为 20.7 岁，横杠患者的平均年龄为 20.1 岁。两组在年龄、性别、平均手术时间方面差异无统计学意义。另一方面，在分析畸形的对称性、患者的家族史和其他异常情况时，发现两组之间具有统计学意义。两组术后住院时间差异有统计学意义，临床可忽略不计。横杠患者术后因浆液性胸腔积液再次入院率显着增加（p  < 0.001）。

结论

虽然需要再入院的胸腔积液在统计学上更常见于横杆，但在可以进行胸腔穿刺术的中心，Nuss 方法仍然可以安全地应用，即使是在有困难、复杂畸形的情况下。

证据级别

三、治疗研究。