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Nuss procedure: decrease in bar movement requiring reoperation with primary placement of two bars.

Amy B Stanfill1, Nerina DiSomma, Steven M Henriques

  • 1Department of Pediatric Surgery, Children's Hospital of Illinois, University of Illinois College of Medicine at Peoria, Peoria, Illinois 61603, USA. amy.b.stanfill@osfhealthcare.org

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|May 15, 2012
PubMed
Summary
This summary is machine-generated.

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Placing two Nuss bars during pectus excavatum repair significantly reduces bar displacement complications. This study found no reoperations for bar movement when two bars were initially placed, compared to 15.5% for one bar.

Area of Science:

  • Thoracic surgery
  • Pediatric surgery
  • Surgical innovation

Background:

  • The Nuss procedure is the preferred surgical treatment for pectus excavatum.
  • Bar displacement is a significant complication, necessitating reoperation in 3.4%-27% of cases.
  • This study investigates using two Nuss bars to improve initial stability.

Purpose of the Study:

  • To compare the incidence of bar displacement requiring reoperation between initial single-bar and double-bar Nuss procedures.
  • To evaluate the effectiveness of placing two Nuss bars in preventing bar movement.

Main Methods:

  • Retrospective chart review of Nuss procedures performed between November 2000 and February 2010.
  • Comparison of outcomes between patients who initially received one Nuss bar versus two Nuss bars.

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  • Data collected included Haller index, demographics, surgical duration, length of stay, infections, and reoperations for bar movement.

    • Main Results:

    • Eighty-five procedures were analyzed (58 one-bar, 27 two-bar).
    • Reoperation for bar movement occurred in 15.5% of patients who received one initial bar.
    • No patients (0%) who received two initial bars required reoperation for bar displacement (P=.05).

    Conclusions:

    • Initial placement of two Nuss bars significantly improves bar stability in pectus excavatum repair.
    • The double-bar technique eliminates the need for reoperation due to bar displacement.
    • This study recommends the primary placement of two Nuss bars as standard practice.