Nuss法による漏斗胸と先天性心疾患の同時手術の経験

摘要

A minimally invasive technique for pectus excavatum repair introduced by Nuss is now widely performed. We utilized this procedure for the simultaneous repair of pectus excavatum and congenital heart disease in two pediatric cases.Median sternotomy was performed first to repair the heart.Next, a pectus bar was introduced under direct vision via median sternotomy and turned over.The sternum was elevated to obtain stability. The cosmetic and functional results were excellent.Compared to a two-staged operation,the simultaneous repair of pectus excavatum and congenital heart disease has the advantage of wide exposure and easy approach to the heart, preventing postoperative circulatory or respiratory complications.Simultaneous repair has been performed utilizing sternal elevation or sternal turnover operations.These operations require excision of deformed cartilage and sternum Bleeding,elongation of operation time,and instability of the chest wall are therefore the main problems.Compared to these operations,the Nuss procedure requires no excision of cartilage and sternum, so bleeding and operation time are reduced,and the chest wall is stabilized soon after surgery. The Nuss procedure is a useful technique for simultaneously repairing pectus excavatum and congenital heart disease in pediatric cases.