Abstract:
:Nuss described a minimally invasive technique for correcting pectus excavatum in children. A curved stainless-steel bar is inserted behind the sternum through the chest cavity with the convex surface face down, then rotated 180 degrees to elevate the sternum and correct the deformity. The procedure gained wide acceptance in children. The purpose of this study was to determine if the procedure is effective in adults. Only patients with symptoms limiting lifestyle, chest wall indices higher than 3.25, and demonstrable cardiac compression on echocardiography were accepted. Between April 1998 and January 2001, 14 adults aged 19 to 46 underwent assessment for the Nuss minimally invasive technique for correction of pectus excavatum. Eight patients, 19 to 32 years of age, met the stated criteria for acceptance. The comorbidities were 2 asymmetrical deformities, 2 scolioses, 1 previous pectus repair, and 1 previous breast augmentation. The patients were informed of the benefits and disadvantages of both the Ravitch and the Nuss procedures. All patients except the first had talked to one or more adults who previously had the procedure. Follow-up was 7 to 37 months (mean 22.1 months). Four patients have had their bars removed and maintained correction. Success of the operation was based on relief of cardiac compression, alleviation of symptoms, and adequate pain control. Operating time was 1 to 2:05 hours (mean 1:32 hours). Complications were pneumothorax in one patient, urinary retention in 2, and left lower lobe atelectasis in 5. Complications did not prolong hospitalization. Postoperative epidural analgesia was discontinued after 2 to 4 days (mean 2.8 days). Average daily pain scores were between 1.6 and 3.7 on a scale of 0 to 10. Hospital stay was 3 to 5 days (mean 4 days). Relief of symptoms and increase in activity were obtained in all patients. Relief of cardiac compression was demonstrated in the 6 patients who have had postoperative echocardiograms. Patients returned to normal activity 2 to 4 weeks postoperatively (mean 2.3 weeks). Duration of pain medicine was 2 to 4 weeks in 6 patients and 2 and 4 months for the other 2 (mean 5.5 weeks). There were 2 late complications related to the bar, but without loss of correction. The early experience with the Nuss minimally invasive pectus excavatum repair in adults is encouraging. The procedure is effective for correcting pectus excavatum in selected patients. Early results are dependent upon adequate bar stabilization and pain control. The long-term results in adults are unknown.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Coln D,Gunning T,Ramsay M,Swygert T,Vera Rdoi
10.1007/s00268-002-6519-xkeywords:
subject
Has Abstractpub_date
2002-10-01 00:00:00pages
1217-21issue
10eissn
0364-2313issn
1432-2323journal_volume
26pub_type
杂志文章abstract::There are now excellent data that patients with stage III colon cancer or stage II and III rectal cancer live longer if they receive, respectively, systemic or regional and systemic therapy after surgery. In addition, disease-free survival, particularly freedom from the symptoms of regional recurrence, in the high ris...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00308633
更新日期:1995-03-01 00:00:00
abstract:INTRODUCTION:Parathyroid cysts are rare but clinically significant lesions. They can be functional, mistaken for a thyroid cyst, and/or managed nonoperatively on occasion. METHODS:We identified seven patients (1 male, 6 females) with the diagnosis of parathyroid cyst from 1998 to 2003. RESULTS:Altogether, 33% of the ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0748-8
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Abdominal packing (AP) in damage-control laparotomy (DCL) is a lifesaving technique that controls coagulopathic hemorrhage in severely injured trauma patients. However, the impact of the duration of AP on the incidence of re-bleeding and on intra-abdominal infections in penetrating abdominal trauma is not cl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1745-3
更新日期:2012-12-01 00:00:00
abstract::Clinical parameters alone have repeatedly been proven unreliable in assessing cardiopulmonary status, especially in hemodynamically unstable patients. To learn if we had a diagnostic problem in our hospital, we compared physician assessment of cardiac index (CI) and thoracic fluid content (TFC) to values obtained usin...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s00268-004-2073-z
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Chronic anal fissure (CAF) is a linear split of the anoderm. The minimally invasive management of CAF such as botulinum toxin (BT) injection is recommended. However, the exact efficient dose of BT, number of injections per session and the injection sites are still debatable. The aim of this analysis was to a...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-016-3693-9
更新日期:2016-12-01 00:00:00
abstract::The pylorus-preserving pancreaticoduodenectomy (PPPD) is an alternative to the standard Whipple resection in the treatment of chronic pancreatitis. The operation is safe and can be performed with a low mortality rate. The most common early complication is delayed gastric emptying, which occurs in 25% to 30% of patient...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7240-0
更新日期:2003-11-01 00:00:00
abstract::Fourteen patients with liver tumor malignancy and sixteen patients with malignant melanoma localized to one limb were studied regarding leukocyte activation with the release of polymorphonuclear neutrophilic (PMN) elastase and of neopterin and formation of cytokines (TNF-alpha and IL-6) during the surgical treatment. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00299787
更新日期:1995-11-01 00:00:00
abstract::Childhood papillary thyroid carcinoma is associated with more locally aggressive and more frequent distant disease than its adult counterpart. Recurrence rates tend to be higher in children, but cause-specific mortality remains low. Optimal initial treatment of childhood papillary thyroid carcinoma should include tota...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-004-7605-z
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Critical limb ischemia (CLI) caused by peripheral arterial disease is associated with significant morbidity and mortality. This condition is associated with a 30 % amputation rate as well as mortality levels which might be as high as 25 %. There is no pharmacological therapy available, but several reports ha...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1892-6
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The only potential cure for neuroendocrine tumors (NETs) is operative resection, which may also offer a survival benefit for advanced disease. We aimed to assess the role of 68Ga-DOTATATE PET/CT in preoperative planning and compared its performance to CT with IV contrast and MRI with Eovist®, for abdominal N...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05216-3
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:The incidence, pattern, and severity of sleep disturbance and cognitive dysfunction has not been well characterized for patients with primary hyperparathyroidism (PHPT). There is no agreement on the mechanism of the development or resolution of such symptoms, and in no previous study has cerebral activity be...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0361-x
更新日期:2006-05-01 00:00:00
abstract::Hepatectomy with concomitant resection of the inferior vena cava (IVC) has become common for hepatic malignancies involving the IVC. However, diagnosing IVC invasion and the procedure of choice have yet to be standardized. Medical records of nine patients with liver cancer (five metastatic tumors from colorectal cance...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6908-9
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Enhanced recovery after surgery (ERAS) programs are designed to reduce hospital length of stay by shortening the postoperative recovery period. The intended effect of an accelerated recovery on the length of stay may be frustrated by a delayed discharge. This study was designed to assess the influence of an ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9404-9
更新日期:2008-06-01 00:00:00
abstract::The development of microsurgical techniques has supplied plastic surgery with a new chance to transfer tissue to nearly any recipient site of the body. Classical methods still have their value but also their limits in many circumstances. Free tissue transfer has proved its advantages, especially in covering defects in...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01670525
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Critical illness disproportionately affects people in low-income countries (LICs). Efforts to improve critical care in LICs must account for differences in demographics and infrastructure compared to high-income settings. Part of this effort includes the development and validation of intensive care unit (ICU...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05078-9
更新日期:2019-10-01 00:00:00
abstract::To illustrate how the high incidence of arrow wounds provided a major stimulus for the development of surgery until a century ago, we conducted a literature search. Our research shows that archaic peoples developed considerable surgical skill for extraction of arrows, including thoracotomy and trephination. A classica...
journal_title:World journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1007/s00268-001-0168-3
更新日期:2001-12-01 00:00:00
abstract:INTRODUCTION:Cardiovascular dysfunction (CVD) is a well-recognized complication in patients with hyperthyroidism and is the major cause of mortality. Very few studies have compared the outcome of CVD following different treatment modalities. In this study we intended to compare treatment modalities (antithyroid drugs v...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4571-4
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Over the past decade, assessments of surgical capacity in low- and middle-income countries (LMICs) have contributed to our understanding of barriers to the delivery of surgical services in a number of countries. It is yet unclear, however, how the findings of these assessments have been applied and built upo...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-014-2938-8
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:In patients with well-differentiated thyroid cancer, the incidence of pathologic central compartment lymph node metastases is reported to be approximately 50%. Recently level VI lymph node dissection has been advocated as a means of reducing recurrence rates in these patients, even if there are no clinically...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1507-2
更新日期:2012-06-01 00:00:00
abstract:PURPOSE:Management of anal fistula represents a balance between curing the condition and maintaining anal continence. Recent reports of the results of the porcine anal fistula plug have demonstrated excellent fistula healing rates without reporting significant complications. METHODS:The outcome of patients who underwe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9504-1
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVES:Postoperative pancreatic fistula (POPF) is a major complication and main cause of mortality after pancreaticoduodenectomy (PD). Afferent loop decompression technique (ALDT) has theoretical feasibility to reduce the rate of POPF. The aim of this study is to determine whether ALDT is a protective factor for PO...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4679-6
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:The optimal timing of VTE prophylaxis initiation after blunt solid organ injury is controversial. Retrospective studies suggest initiation ≤48 h is safe. This prospective study examined the safety and efficacy of early VTE prophylaxis initiation after nonoperative blunt solid organ injury. METHODS:All patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05096-7
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Medullary thyroid cancer (MTC) disseminates early to lymph nodes (LN). There is no pre- or intraoperative marker to exclude LN involvement and thereby avoid lateral neck dissection in LN-negative patients. MATERIALS AND METHODS:This study was intended to verify the observation that patients with MTC lacking...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0391-4
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Postoperative ascites is a common complication after liver resection. This study aimed to identify the risk factors for ascites in patients after liver resection and the relationship between postoperative ascites and other complications. METHODS:We retrospectively analyzed data that were obtained from 266 p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4003-x
更新日期:2017-08-01 00:00:00
abstract::Resection remains the treatment of choice in liver cancer. In order to avoid liver transplantation in conventionally unresectable tumors ex-situ ("bench" procedure), in-situ and ante-situm resection technique should be preferred whenever feasible. Despite the deficiency of donor organs, a single center experience with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00299775
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Appendiceal neuroendocrine tumors (aNET) are a common entity in routine medical care, with a rate per appendectomy as high as 0.3-0.9 %. Considering the relatively young age at diagnosis for these patients, exact information about the long-term prognosis of aNET is required. Survival rates vary substantially...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3164-8
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Postoperative outcome prediction in elderly is based on preoperative physical status but its predictive value is uncertain. The goal was to evaluate the value of risk assessment performed perioperatively in predicting outcome in case of admission to an intensive care unit (ICU). METHODS:A total of 108 posts...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05742-5
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:In uremic patients, metabolism of 1-84 parathyroid hormone (PTH) and fragments are delayed, and in these patients, the usefulness of intraoperative PTH assay may be problematic. We evaluated the usefulness of the QuiCk-IntraOperative Bio-Intact PTH (QPTH) assay for uremic patients with secondary hyperparathy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0601-8
更新日期:2007-04-01 00:00:00
abstract::Nineteen consecutive patients receiving renal transplants underwent prospective evaluation of their calcium homeostasis for 1 year after transplantation to characterize indices of hyperparathyroidism (HPT) amelioration. All but one underwent dialysis, and six had vitamin D supplementation before grafting. The rapid fa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900446
更新日期:1998-06-01 00:00:00
abstract::Breast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n=1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were se...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7040-6
更新日期:2004-01-01 00:00:00