Long term results in children underwent nuss procedure preschool with pectus excavatum: Real-world study with propensity matching
Quan Wang,
Xiangpan Kong,
Chunian Ren,
Zhengxia Pan,
Chun Wu,
Hongbo Li,
Yonggang Li,
Gang Wang,
Jiangtao Dai
Affiliations
Quan Wang
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
Xiangpan Kong
Department of Urology, Children's Hospital of Chongqing Medical University, China
Chunian Ren
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
Zhengxia Pan
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
Chun Wu
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
Hongbo Li
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
Yonggang Li
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
Gang Wang
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
Jiangtao Dai
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China; Corresponding author. Children's Hospital of Chongqing Medical University, No.136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, China
Background: It is controversial when surgery should be performed for pectus excavatum (PE). The study retrospectively compared the long-term prognosis in PE children undergoing the Nuss procedure at the age of 4–6 versus those performing surgery at the age of 12–14. Methods: 178 patients were included in the retrospective real-world research. Clinical Characteristics were collected at baseline. The endpoint of the study was set as the last follow-up at the age of 18 in outpatient services. Satisfaction and complication rate were set as the primary outcome and were collected at the endpoint. Hospital stay post-surgery and analgesia dosage were regard as the secondary outcome. To reduce potential bias between two different age groups, propensity score matching (PSM) analysis was analysized. Results: The oral analgesic dosage of children in the 4–6 years old age group is significantly lower than that of the 12–14 years old group (0.70/kg, 0.30–1.50/kg versus 1.50/kg, 0.90–2.30/kg, P < 0.001), and children in the younger age group are discharged earlier. There was no difference in overall satisfaction (89.1 %, versus 88.20 %, P = 0.99) and recurrence rate (7.2 %, versus 6.8 %, P = 0.99) between the two groups of when they reach the age of 18. Conclusions: Performing Nuss procedure at the age of 4–6 does not affect the overall long-term satisfaction of the child or increase the long-term recurrence rate. Surgical intervention in children with pectus excavatum preschool can provide a better postoperative experience in hospital compared with intervention in adolescent.
