• Journal of Chest Surgery
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• 제51권6호
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• pp.390-394
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• 2018

Background: The nonsurgical treatment of chest wall deformity by a vacuum bell or external brace is gradual, with correction taking place over months. Monitoring the progress of nonsurgical treatment of chest wall deformity has relied on the ancient methods of measuring the depth of the excavatum and the protrusion of the carinatum. Patients, who are often adolescent, may become discouraged and abandon treatment. Methods: Optical scanning was utilized before and after the intervention to assess the effectiveness of treatment. The device measured the change in chest shape at each visit. In this pilot study, patients were included if they were willing to undergo scanning before and after treatment. Both surgical and nonsurgical treatment results were assessed. Results: Scanning was successful in 7 patients. Optical scanning allowed a visually clear, precise assessment of treatment, whether by operation, vacuum bell (for pectus excavatum), or external compression brace (for pectus carinatum). Millimeter-scale differences were identified and presented graphically to patients and families. Conclusion: Optical scanning with the digital subtraction of images obtained months apart allows a comparison of chest shape before and after treatment. For nonsurgical, gradual methods, this allows the patient to more easily appreciate progress. We speculate that this will increase adherence to these methods in adolescent patients.

• Journal of Chest Surgery
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• 제39권10호
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• pp.765-769
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• 2006

배경: 너스 시술은 누두흉 환자들의 전흉부 함몰을 교정하는 효과적인 수술방법으로 기존의 방법에 비하여 비침습적이다. 하지만 환자의 나이와 기형 형태에 따라 전흉부 함몰은 다양한 양상을 보이는 데, 이에 대하여 고전적인 너스 시술만을 고집할 때 기형 재발, 불충분 교정 등 다수의 합병증이 발생하였다. 따라서 저자들은 고전적인 너스 술식을 몇 가지 관점에서 보완하였다. 대상 및 방법: 1999년 11월부터 2004년 12월까지 135명의 환자와 216건의 수술경험을 후향적으로 분석하였다. 수술 전 컴퓨터 단층촬영, 수술 당시 환자의 연령, 수술방법, 재발을 포함한 합병증 여부를 분석하고, 이를 시술의 개선 전후로 나누어 비교하였다. 결과: 5년 2개월 동안 135명에서 너스 술식을 시행하였으며, 너스막대 제거술 64건, 재발 또는 합병증을 이유로 2번 이상의 너스 술식을 시행한 17건을 포함하여 너스 관련 216건의 수술을 시행하였다. 막대의 삽입위치를 절개부위에서 함몰부의 양족 경계부(늑연골의 최대 돌출부위)로 내측으로 이동시켜 흉곽 지지구조의 손상을 최소화하였고, 막대 성형 시 늑골과 접합하는 부분을 늑골모양에 맞게 성형하여 막대의 미끄러짐 현상을 줄였다. 그리고 막대와 늑골의 고정사를 바이크릴에서 강선으로 전환하고, 성인 환자의 경우, 수술 중 흉골을 견인하는 방법을 추가하였다. 1999년에서 2002년까지 17건에 달하던 재교정과 23건의 합병증이 개선 이후인 2003-2004년에는 재교정 0건, 합병증 3건으로 감소하였다. 결론: 이러한 결과로 미루어 보아, 본원에서 시행한 너스개선 술식은 효과적이었으며, 재발과 합병증을 획기적으로 줄일 수 있었다.

• Journal of Chest Surgery
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• 제37권6호
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• pp.536-538
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• 2004

선천성 심기형과 흉벽기형이 동반되어 있는 경우 이 두 질환을 동시에 수술하는 경우에 변형된 늑연골의 광범위한 절제에 따른 합병증이 단점으로 지적되고 있다. 본원 흉부외과에서는 부분 방실중격 결손증과 오목가슴이 동반된 8세 환아에서 개심술 시에 Nuss 술식을 이용하여 오목가슴을 교정함으로써 광범위한 늑골절제에 따른 수술시간의 지연이나 출혈, 흉벽의 불안정성 등의 단점없이 좋은 결과를 얻었기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제19권3호
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• pp.479-483
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• 1986

Two patients with funnel chest deformity were corrected at the Department of Thoracic Surgery of Chosun University Hospital. The first case was 5 year old boy, suffering cosmetic deformity, of which hollow cavity was measured 25ml of water. He was corrected by modified Ravitch method. The second case was 12 year old boy, suffering from exertional dyspnea with symmetrical funnel chest deformity, of which hollow cavity was measured 55ml of water. He was corrected by method of sternal turnover. The surgical results of these cases were satisfactory.

• Journal of Chest Surgery
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• 제35권12호
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• pp.882-889
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• 2002

누두흉 환자에 대해 최소침습적 방법으로 전흉벽 늑연골의 리모델링 성형술이 선호되고 있다. 본원에서 시행한 누두흉 환자들을 대상으로 늑연골의 리모델링 성형술의 시행시 발생할 수 있는 초기 합병증의 종류와 이에 대한 치료법의 연구이다. 대상 및 방법: 본원에서 1999년 9월에서부터 2002년 2월까지 오목가슴으로 인해 늑연골의 리모델링 성형술을 시행받은 55명을 대상으로 의무기록을 중심으로 후향적 분석을 시행하였다. 입원기간, 수술 후 관리, 수술 후 한 달 내에 발생한 합병증과 치료 방법 등을 분석하였다. 결과: 입원일은 5일에서 29일(8.6$\pm$4.2일)이었고 특별한 합병증이 없어도 퇴원하는 날까지 단순흥부촬영을 매일 시행하였으며 55명중 수술 후 합병증이 발생한 환자는 28명(51%)이었으며 기흉이 11명(20%), 혈흉이 6명(11%), 혈기흉이 3명(5%)이었으며 그 외 폐렴 및 무기폐등이 발생하였고 이중 3명(3%)은 상기 합병증과 더불어 철심의 변위 및 상처감염이 발생하였다. 28명의 합병증이 발생한 환자들 중 흉관삽입술이나 치료가 필요했던 환자들은 7명(13%)이었다. 결론: 늑연골의 리모델링 성형술후에 발생하는 합병증과 그의 치료에 대해 대부분의 환자들에서는 특별한 치료가 필요하지 않았으나 좀더 오랜 기간 추적관찰이 필요하다.

• Journal of Chest Surgery
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• 제25권8호
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• pp.837-843
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• 1992

The most common deformity of the sternum is the depression deformity, variously calid pectus Excavatum, funnel chest, schwusterbrust, trichterburst, thorax en entonnoir. During the period 1983 to 1991 a total of 15 cases of funnel chest were treated surgically at Department of Thoracic Surgery, Hanyang University Hospital. The age at the time of operation ranged from 4 to 26 years 73.3 percent of the patients were under 12 years of age They all had symptoms of feeling Inferiority about chest deformity. The concavity on the funnel chest varied in its Extent, and the severity, which was measured by water volume filled into it, varied from 45ml to 100ml. We have Experienced 15 cases of pectus Exc-avatum with several operative method, i.e., Ravitch operation in 2 cases, Taguchi operation in 3 cases[using by Both IMA], Adkins operation in 5 cases, Modified wada operation [sternal costal cartilage Elevation Technique] in 5 cases. After surgery, follow up vertebral Index showed 44%, preoperatively and 29% postoperatively, average decrement of 15%. We Reported 15 cases of funnel chest and the surgical results of thease cases were satisfactory Except one case of Ravitch operation.

• Journal of Chest Surgery
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• 제19권4호
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• pp.699-706
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• 1986

We have experienced 5 cases of Pectus excavatum corrected by Ravitch method without use of K-wire or metal bar from Jan. 1985 to Apr. 1986. All cases were male. The symmetric depression was in 4 cases, asymmetric one was in one case. The chief complaints were dyspnea on exertion, frequent U.R.I. and inferiority. The flail chest was developed in all cases, but it was insignificant in all cases except one who needed assist ventilation. Mediastinitis was developed in one case one week postoperatively but well managed with drainage. A distance from the posterior surface of sternum to the anterior surface of vertebral body was estimated preoperatively and postoperatively. Postoperative result was evaluated as the change of distance postoperatively. The change was 1.5cm minimally to 3.5cm maximally. Late results were "Excellent" in 3 cases and "Good" in 2 cases.uot; in 2 cases.

• 대한기관식도과학회지
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• 제3권1호
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• pp.128-136
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• 1997

저자들은 Patau증후군에 동반된 후두연화증으로 심폐정지가 유발된 환아에서 $CO_2$레이저를 이용한 aryepiglottoplasty를 시행하여 극적인 호전을 보였기에 문헌고찰과 함께 치료경험을 보고하는 바이다.

• Journal of Chest Surgery
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• 제52권1호
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• pp.55-57
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• 2019

Robotically assisted mitral valve repair has proven its efficacy during the last decade. The most suitable approach for patients with difficult anatomies, such as morbid obesity, sternal deformities, cardiac rotation, or vascular anomalies, represents a current challenge in cardiac surgery. Herein, we present the case of a 71-year-old patient affected by severe degenerative mitral valve regurgitation with pectus excavatum and a right aortic arch with an anomalous course of the left subclavian artery who was successfully treated using a Da Vinci-assisted approach.

• Journal of Chest Surgery
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• 제48권2호
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• pp.112-119
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• 2015

Background: Pectus excavatum (PE) is the most common chest wall deformity. The Nuss Questionnaire modified for Adults (NQmA) is a disease-specific health-related quality of life assessment tool for patients with pectus deformities. The aim of this study is to adapt the NQmA into Turkish. Methods: Two hundred and sixty-five patients with PE were participated, with an age range of 14 to 29 years. All patients underwent a physical examination and had not undergone corrective surgery. The Turkish version of the NQmA was completed by patients and their parents. Results: The content validity index based on expert opinions was 91% for the patient questionnaire and 96% for the parent questionnaire. The Cronbach's alpha value for the NQmA was found to be 0.805 for the patient questionnaire and 0.800 for the parent questionnaire. Exploratory factor analysis was used to assess construct validity. Two factors explained 51.1% of the total variance in the patient questionnaire (psychosocial: 31.145%, Cronbach's alpha=0.818; physical: 19.955%, Cronbach's alpha=0.862). In the parent questionnaire, two factors explained 51.422% of the total variance (psychosocial: 26.097%, Cronbach's alpha=0.743; physical: 25.325%, Cronbach's alpha=0.827). Construct validity was confirmed by confirmatory factor analysis. Conclusion: The Turkish version of the NQmA was found to be valid and reliable for the assessment of quality of life in patients with PE.