39. INCIDENCE OF BAR INFECTIONS AND RELATED FACTORS FOLLOWING THE NUSS PROCEDURE FOR PECTUS EXCAVATUM
Main Article Content
Abstract
Objective: Determine the rate and related factors of bar infections following the Nuss procedure for congenital pectus excavatum at the University Medical Center Ho Chi Minh City.
Methods: A retrospective study was conducted at the University Medical Center Ho Chi Minh City, analyzing the medical records of 218 patients with pectus excavatum who underwent the Nuss procedure from January 2019 to May 2024. Data included demographic characteristics, surgical techniques, and postoperative outcomes. Statistical analyses, such as t-tests and chi-squared tests, were used to identify significant infection risk factors.
Results: The bar infection rate was 1.4% (3/218), lower than the previously reported rate of 4%. Infections were significantly associated with asymmetric chest morphology and double bar usage. All infected patients had asymmetric chests (100%, p = 0.031), and 85.71% used double bars (p = 0.008). Longer surgical duration was also linked to higher infection risk (100 ± 17.32 minutes for infected vs. 69.54 ± 26.41 minutes for non-infected, p = 0.042).
Conclusion: Our study indicates that the rate of bar infections following the Nuss procedure is lower than in previous studies. However, significant risk factors such as asymmetric chest morphology, double bar usage, and prolonged surgical duration remain. Enhancing preventive measures and optimizing surgical techniques are necessary to minimize complications and improve treatment outcomes.
Article Details
Keywords
Pectus excavatum, complications, bar infection
References
[2] Calkins CM, Shew SB, Sharp RJ, et al.: Management of postoperative infections after the minimally invasive pectus excavatum repair. J Pediatr Surg. 2005, 40:1004-1007; discussion 1007-1008. 10.1016/j.jpedsurg.2005.03.017
[3] Castellani C, Schalamon J, Saxena AK, Höellwarth ME: Early complications of the Nuss procedure for pectus excavatum: A prospective study. Pediatr Surg Int. 2008, 24:659-666. 10.1007/s00383-008-2106-z
[4] Obermeyer RJ, Godbout E, Goretsky MJ, et al.: Risk factors and management of Nuss bar infections in 1717 patients over 25 years. J Pediatr Surg. 2016, 51:154-158. 10.1016/j.jpedsurg.2015.10.036
[5] Shin S, Goretsky MJ, Kelly RE, Jr., Gustin T, Nuss D: Infectious complications after the Nuss repair in a series of 863 patients. Journal of Pediatric Surgery. 2007, 42:87-92. 10.1016/j.jpedsurg.2006.09.057
[6] Lâm Văn Nút: Nghiên cứu ứng dụng phẫu thuật NUSS trong điều trị lõm ngực bẩm sinh. Luận án Tiến sỹ y học - Đại học Y Dược TP. Hồ Chí
Minh; 2014.
[7] Akhtar M, Razick DI, Saeed A, et al.: Complications and Outcomes of the Nuss Procedure in Adult Patients: A Systematic Review. Cureus.
2023, 15:e35204. 10.7759/cureus.35204
[8] Chen HYM, Cheng WYR, Chan H, Ng WS: Associated risk factors for patients undergoing a unique or double Nuss bar placement for pectus
excavatum. Asian Cardiovasc Thorac Ann. 2023, 31:221-228. 10.1177/02184923221142165