Pectus excavatum is the most common chest wall deformity. Severe pectus excavatum can significantly impact both the physiological and psychological health of patients, necessitating timely therapeutic intervention. The Nuss procedure is currently the preferred surgical approach for treating moderate to severe pectus excavatum. However, in cases of severe pectus excavatum, the placement of the corrective steel bar through the anterior mediastinum poses a substantial risk of injury to the heart, major blood vessels, and lung tissue. This article reports a case of a 17-year-old patient with severe pectus excavatum combined with Marfan syndrome. CT examination revealed a Haller index of 14.07, with severe sternal depression leading to significant narrowing of the anterior mediastinal space and complete displacement of the heart into the left thoracic cavity, resulting in an extremely high surgical risk. We employed a simplified sternal elevation technique in conjunction with the Nuss procedure for treatment. During the operation, a sternal retractor was used to elevate the sternum, thereby enlarging the retrosternal space and facilitating the successful completion of the Nuss procedure. This approach effectively avoided damage to the heart and major blood vessels, resulted in no surgical complications, and achieved a satisfactory corrective outcome.
In recent years, with the improvement of people's awareness of physical examination and the more accurate detection equipment, the detection rate of pulmonary nodules is getting higher and higher. Surgical resection is the first choice for the treatment of malignant pulmonary nodules, but multiple pulmonary nodules, nodules in complex areas and those with surgical contraindications are not suitable for surgery. As an effective, less invasive and low-cost treatment, ablation has developed rapidly in the treatment of multiple pulmonary nodules. This article introduces the progress of several common ablation techniques (radiofrequency ablation, microwave ablation, cryoablation) in the treatment of multiple pulmonary nodules, the indications and contraindications of ablation techniques, the efficacy evaluation and complications after ablation therapy, and the prospects of ablation techniques in the treatment of multiple pulmonary nodules.
Objective To explore the clinical application effect and technical advantages of percutaneous suspension technique via sternal elevation device-assisted pectus excavatum (PE) correction. Methods Patients who underwent percutaneous suspension technique via sternal elevation device-assisted PE correction at West China Hospital of Sichuan University from July to August 2025 were consecutively enrolled, and their clinical data were analyzed. Results A total of 5 PE patients were included in the study, including 4 males and 1 female, aged 14 to 27 years, and the preoperative Haller index ranged from 3.44 to 7.65. Among them, 4 patients underwent PE correction assisted by percutaneous suspension technique via balance-shaped sternal elevation device, and one underwent PE correction assisted by percutaneous suspension technique via single sternal elevation device. All operations were completed successfully, with a significant expansion of the retrosternal space, smooth implantation of the steel plate, and no complications. The operation time ranged from 29 to 48 minutes, and the intraoperative blood loss was 2 to 5 mL. The patients recovered well after surgery, and the satisfaction rate with thoracic wall appearance correction was 100%. Conclusion The percutaneous suspension technique via sternal elevation device-assisted PE correction can safely expand the retrosternal operating space. This crucial expansion reduces surgical risks and optimizes the orthopedic outcome, underscoring its significant clinical value for minimally invasive treatment of PE.