{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:35:30Z","timestamp":1753893330307,"version":"3.41.2"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Nuss procedure is the most common method of surgical treatment to pectus excavatum (PE). A significant percentage of surgeons choose to use thoracoscopic assistance during the Nuss procedure (TNP) to avoid cardiac injury. However, our previous findings confirm the safety of single incision Non-thoracoscopic Nuss Procedure (SINTNP). Hence, Further studies, particularly prospective randomized controlled trials, are necessary to assess the value of SINTNP for PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is a prospective, superiority, multicenter, non-masked, randomized controlled trial that investigates the outcome and hospitalization medical expense of SINTNP compared to TNP for PE. A total of 320 eligible patients according to sample size calculation by retrospective data will be randomly assigned to the SINTNP group or the TNP group at a 1:1 ratio using stratified blocked randomization and the zone length was set as four. Patients aged between 3 and 18 years old for the first surgery and without combination of complex anomalies such as Marfan syndrome and congenital heart disease will be considered for the study. The co-primary endpoint is thoracic related complications and medical expense during hospitalization. Thoracic related complications were defined as pneumothorax, pleural effusion, pneumonia and incision infection. The secondary endpoints include surgery duration and length of hospital stay.<\/jats:p><jats:p>The registration number for this study protocol is ChiCTR230073081 (Chinese Clinical Trial Registry, A Primary Registry of International Clinical Trial Registry Platform, World Health Organization).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1210452","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T06:43:56Z","timestamp":1689749036000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Single Incision non-thoracoscopic Nuss procedure for children with pectus excavatum: protocol for a multicenter, non-masked, randomized controlled trial"],"prefix":"10.3389","volume":"10","author":[{"given":"Quan","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengxia","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonggang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiangtao","family":"Dai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunnian","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiming","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liangjun","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Libing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbo","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e496","DOI":"10.1097\/SLA.0000000000003877","article-title":"Recent modifications of the Nuss procedure: the pursuit of safety during the minimally invasive repair of pectus Excavatum","volume":"275","author":"Kelly","year":"2022","journal-title":"Ann Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"208","DOI":"10.21037\/tp-22-361","article-title":"The management of pectus excavatum in pediatric patients: a narrative review","volume":"12","author":"Scalise","year":"2023","journal-title":"Transl Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/S0022-3468(98)90314-1","article-title":"A 10-year review of a minimally invasive technique for the correction of pectus excavatum","volume":"33","author":"Nuss","year":"1998","journal-title":"J Pediatr Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/S0022-3468(00)90019-8","article-title":"Outcome analysis of minimally invasive repair of pectus excavatum: review of 251 cases","volume":"35","author":"Hebra","year":"2000","journal-title":"J Pediatr Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1097\/SLA.0b013e3181effdce","article-title":"Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1215 patients","volume":"252","author":"Kelly","year":"2010","journal-title":"Ann Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1007\/s00383-015-3694-z","article-title":"Minimally invasive repair of pectus excavatum: analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions","volume":"31","author":"Sacco-Casamassima","year":"2015","journal-title":"Pediatr Surg Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1016\/j.ejcts.2008.07.068","article-title":"Efficacy and safety of modified bilateral thoracoscopy-assisted Nuss procedure in adult patients with pectus excavatum","volume":"34","author":"Cheng","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"202","DOI":"10.21037\/atm.2019.05.03","article-title":"Surgical management of pectus excavatum in China: results of a survey amongst members of the Chinese association of thoracic surgeons","volume":"7","author":"Shi","year":"2019","journal-title":"Ann Transl Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1093\/ejcts\/ezz038","article-title":"Behavioural disorders in children with pectus excavatum in China: a retrospective cohort study with propensity score matching and risk prediction model","volume":"56","author":"Li","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"831617","DOI":"10.3389\/fped.2022.831617","article-title":"The safety and efficacy of the modified single incision non-thoracoscopic Nuss procedure for children with pectus Excavatum","volume":"10","author":"Song","year":"2022","journal-title":"Front Pediatr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"200","DOI":"10.7326\/0003-4819-158-3-201302050-00583","article-title":"SPIRIT 2013 Statement: defining standard protocol items for clinical trials","volume":"158","author":"Chan","year":"2013","journal-title":"Ann Intern Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/j.jamcollsurg.2013.06.019","article-title":"Multicenter study of pectus excavatum, final report: complications, static\/exercise pulmonary function, and anatomic outcomes","volume":"217","author":"Kelly","year":"2013","journal-title":"J Am Coll Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1053\/j.sempedsurg.2008.03.003","article-title":"Minimally invasive surgical repair of pectus excavatum","volume":"17","author":"Nuss","year":"2008","journal-title":"Semin Pediatr Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e0233547","DOI":"10.1371\/journal.pone.0233547","article-title":"The Nuss procedure for pectus excavatum: an effective and safe approach using bilateral thoracoscopy and a selective approach to use multiple bars in 296 adolescent and adult patients","volume":"15","author":"Lo","year":"2020","journal-title":"PLoS One"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1016\/j.jpedsurg.2018.02.089","article-title":"Minimally invasive repair of pectus excavatum: analysis of the NSQIP database and the use of thoracoscopy","volume":"53","author":"Tetteh","year":"2018","journal-title":"J Pediatr Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"17534666231155779","DOI":"10.1177\/17534666231155779","article-title":"Academic performance in children with pectus excavatum: a real-world research with propensity score matching","volume":"17","author":"Li","year":"2023","journal-title":"Ther Adv Respir Dis"},{"key":"B17","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1016\/j.jtcvs.2020.11.154","article-title":"Minimally invasive repair of pectus excavatum by the Nuss procedure: the learning curve","volume":"163","author":"de Loos","year":"2022","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1210452\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T06:44:19Z","timestamp":1689749059000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1210452\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,19]]},"references-count":17,"alternative-id":["10.3389\/fsurg.2023.1210452"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2023.1210452","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2023,7,19]]},"article-number":"1210452"}}