來源:J Laparoendosc Adv Surg Tech A. 2011 Jan-Feb;21(1):93-6. Epub 2011 Jan 8.
Treatment of pectus excavatum in patients over 20 years of age.
廿歲以上漏斗胸病人的治療
一般來漏斗胸的最佳治療時機是在18歲以前; 因為年紀太太時胸骨等彈性較差, 復原也較慢.
本文作著以19位20至27歲的病人治療經驗分析顯示, 若用了較強支撐之矯正板及止痛, 結果仍與年輕族群相似.
MATERIALS AND METHODS: From May 2003 to September 2009, 19 patients presenting PE (group 1), aged 20-27 years, underwent NP. A modified operation was performed in 10 patients using the scope at the axilla; the bar needed hyperconvex modeling in the middle and extended internal curving of its extremities before rotation at the thorax. A new and more resistant bar was designed and was used in the last 5 patients. Two stabilizers were implanted in 11 cases. Group 1 patients were compared with a group of 26 teenagers operated on before 20 years of age (group 2) during the same period.
RESULTS: All operations could be performed despite the more intense rigidity of the anterior thoracic wall in group 1. It was easier in the last patients who received thicker bars. After the third postoperative day, the operations were more painful in group 1, requiring more potent analgesic drugs. However, the adults were more tolerant and complained less than most patients of group 2. There were no differences between the two groups in operative times, complications, or hospitalization.
CONCLUSIONS: Patients with PE can be operated on during the third decade of life by the NP, facilitated by compensating bending of the bar, a stronger bar, and the use of potent analgesics, leading to outcomes similar to those in younger patients.
Treatment of pectus excavatum in patients over 20 years of age.
廿歲以上漏斗胸病人的治療
一般來漏斗胸的最佳治療時機是在18歲以前; 因為年紀太太時胸骨等彈性較差, 復原也較慢.
本文作著以19位20至27歲的病人治療經驗分析顯示, 若用了較強支撐之矯正板及止痛, 結果仍與年輕族群相似.
MATERIALS AND METHODS: From May 2003 to September 2009, 19 patients presenting PE (group 1), aged 20-27 years, underwent NP. A modified operation was performed in 10 patients using the scope at the axilla; the bar needed hyperconvex modeling in the middle and extended internal curving of its extremities before rotation at the thorax. A new and more resistant bar was designed and was used in the last 5 patients. Two stabilizers were implanted in 11 cases. Group 1 patients were compared with a group of 26 teenagers operated on before 20 years of age (group 2) during the same period.
RESULTS: All operations could be performed despite the more intense rigidity of the anterior thoracic wall in group 1. It was easier in the last patients who received thicker bars. After the third postoperative day, the operations were more painful in group 1, requiring more potent analgesic drugs. However, the adults were more tolerant and complained less than most patients of group 2. There were no differences between the two groups in operative times, complications, or hospitalization.
CONCLUSIONS: Patients with PE can be operated on during the third decade of life by the NP, facilitated by compensating bending of the bar, a stronger bar, and the use of potent analgesics, leading to outcomes similar to those in younger patients.
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