早期漏斗胸的納氏手術, 大多用鋼絲來固定, 但隨著經驗增加, 大多數還是採用固定片, 而不再用鋼絲. 

最近又有一些病友來問是否用鋼絲固定就可以了, 據早期的個人的統計, 鋼絲在體內斷裂的發生率是47%, 但一直沒有其他的論文來支持我的發現,

今天讀到這篇論文, 與我的觀點相合:Am Surg. 2016 Sep; 82(9): 781–782.

Complications associated with bar fixation following Nuss repair for pectus excavatum

論文中題到:

Six  had a complication related to bar fixation and position. Five  patients had broken wires, three requiring an operative procedure: Two because of pain, the third for a late pneumothorax (one month postoperatively) caused by the sharp end of the wire protruding into the pleural cavity . Three broken wires that had not caused overt problems or symptoms were found incidentally at the time of bar removal at the end of the period of surgical fixation. 

(本論文有11位病人採用鋼絲固定,)

與固定方式相關的併發症有6例, 其中有5例是因鋼絲斷裂, 其中3位需要外科手術治療,(2位因疼痛, 1位因斷裂鋼絲刺破肋膜腔而引起氣胸), 3條斷裂鋼絲未引起問題, 是意外發現, 

11位用鋼絲固定的病人有5位鋼絲在體內斷裂, 高達45.5%, 與我的統計47%很接近, 有這麼高比率的併發症, 還要用鋼絲嗎?