Preliminary exploration on the feasibility of using azygos vein to reconstruct superior vena cava reconstruction

Objective To evaluate the thoracic status of patients with funnel chest by quantitative evaluation of chest X-ray, and to explore the effect of Nuss surgery. Methods From October 2006 to February 2011, according to the inclusion criteria, there were 47 cases enrolled our group at last, then divided the cases into 3 groups, including pre-operative of Nuss procedure, recent post-bar removal and further post-bar removal. We measured data on chest radiography and statistical analysis, including the maximal distance of the outer boundary of each rib pairs(C, from the 1st pair to the 9th), the distance between lung apex to the costophrenic angle(H) and the distance between the two costophrenic angles(W). Results All the 47 cases completed the Nuss procedure and Nuss bar removal safely and effectively. All the patients were followed up from 30 to 36 months, without recurrence or long-term complications. Three groups of thoracic data showed an increasing trend, recent post-bar removal and further post-bar removal compared with the same age normal children, the thoracic data of the Nuss bar position were shortened. With the prolongation of time after Nuss bar removal, thoracic data gradually approaching normal. Conclusion We can evaluate the level of pectus excavatum and effect of Nuss procedure through measuring the chest wall data. The chest wall of post-bar removal was significantly improvement compared to the cases of pre-Nuss procedure. There is some restrictions on the thoracic by the Nuss bar. we learn that the limitation of thoracic can be improve after some time. Key words: Pectus excavatum; Nuss procedure; Chest wall