Child pectus excavatum: correction by minimally invasive surgery

Area of Science:

• Thoracic surgery
• Pediatric surgery
• Minimally invasive procedures

Background:

• Pectus excavatum (PE) is a congenital chest wall deformity often treated with open reconstruction or the Nuss procedure.
• The Nuss technique involves raising the sternum using a retrosternal metallic bar placed under thoracoscopic guidance.

Purpose of the Study:

• To present the preliminary results of the Nuss procedure in a series of 25 children with pectus excavatum.
• To evaluate the safety, efficacy, and cosmetic outcomes of this minimally invasive technique.

Main Methods:

• Twenty-five children with PE underwent the Nuss procedure between February 2004 and April 2007.
• The technique involved retrosternal bar placement via lateral incisions, often with thoracoscopic guidance.
• Follow-up included assessments of pain, cosmetic satisfaction, and respiratory function.

Main Results:

• Excellent cosmetic results were reported by 24 out of 25 patients.
• Minor complications occurred in five patients, with no long-term impact.
• One case of bar displacement required revision, with subsequent uncomplicated recovery.

Conclusions:

• The Nuss procedure is a valid and effective surgical strategy for treating pectus excavatum, particularly in cosmetic indications.
• Technique modifications, such as dual-bar implantation and subxiphoid approaches, improve outcomes in severe or complex cases.
• The Nuss technique offers reliable and aesthetically pleasing results with minimal scarring.