J Korean Med Sci.  2007 Apr;22(2):254-257. 10.3346/jkms.2007.22.2.254.

A Comparative Study of Pericostal and Submuscular Bar Fixation Technique in the Nuss Procedure

• Kim HK
• Choi YH
• Cho YH
• Ryu SM
• Sohn YS
• Kim HJ

• KMID: 1713180
• DOI: http://doi.org/10.3346/jkms.2007.22.2.254

Abstract

We evaluated the safety and stability of the less-invasive submuscular bar fixation method in the Nuss procedure. One hundred and thirteen patients undergoing the Nuss procedure were divided into three groups according to the bar fixation technique employed. Group 1 consisted of 25 patients who had undergone bilateral pericostal bar fixation, group 2 consisted of 39 patients with unilateral pericostal one, and group 3 included 49 patients with bilateral submuscular one. The patients' age ranged from 2 to 25 yr, with an average of 7.2+/-5.67 yr. Bar dislocation occurred in 1 patient (4%) in Group 1, 2 patients (5.1%) in Group 2, and 1 patient (2.0%) in Group 3 (p=0.46). Hemothorax was noted in 2 patients (8%) in Group 1, 2 (5.1%) in Group 2, and none (0%) in Group 3 (Group 1 vs. Group 3, p=0.028). The mean operation time was shorter in Group 3 than Group 1 (50.1+/-21.00 in Group 3 vs. 67.2+/-33.07 min in Group 1, p=0.041). The submuscular bar fixation results in a decrease in technique-related complications and operation time and is associated with favorable results with regard to the prevention of bar dislodgement.

Keyword

Funnel Chest; Postoperative Complication; Hemothorax; Pneumothorax; Reoperation

MeSH Terms

Treatment Outcome
Thoracic Surgical Procedures/*instrumentation/*methods
Surgical Procedures, Minimally Invasive/instrumentation/methods
Ribs/surgery
Reconstructive Surgical Procedures/*instrumentation/*methods
*Prostheses and Implants
Male
Humans
Funnel Chest/*surgery
Female
Child, Preschool
Child
Adult
Adolescent
Abdominal Muscles/surgery

Figure

• 

  Fig. 1 (A) The serratus anterior muscle is dissected away from the ribs via electrocauterization, then sutured with PDS 1-0 in order to firmly secure the bar. (B) Bar is inserted into the submuscular area.

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