Can absorbable stabilizers be used routinely in the Nuss procedure?

Area of Science:

• Thoracic Surgery
• Biomaterials Science
• Minimally Invasive Surgery

Background:

• Pectus excavatum repair often involves metal stabilizers that can cause chronic pain and require removal.
• Recently, slowly absorbable Lactosorb stabilizers have been introduced as an alternative.

Purpose of the Study:

• To compare the outcomes of metal stabilizers versus absorbable Lactosorb stabilizers in minimally invasive pectus excavatum repair.
• To assess the incidence of complications associated with each type of stabilizer.

Main Methods:

• A retrospective analysis of 507 patients who underwent minimally invasive pectus excavatum repair between 2001 and 2008.
• Comparison of outcomes between patients who received metal stabilizers (n=422) and those who received Lactosorb stabilizers (n=85).

Main Results:

• Lactrosorb stabilizers showed a higher rate of failure, with 3.5% breaking and 3.5% dislocating within 6 weeks post-surgery.
• Metal stabilizers had a lower failure rate, with only 0.2% breaking over a longer follow-up period.

Conclusions:

• Absorbable Lactosorb stabilizers are more vulnerable and prone to mechanical failure compared to metal stabilizers in pectus excavatum repair.
• The higher failure rate may be linked to increased stress forces, potentially exacerbated by the use of shorter pectus bars.