[Repair of pectus excavatum without the introduction of exogenous material]

We review our experience of surgical repair for pectus excavatum without the introduction of exogenous material. Two hundred seven patients underwent surgical repair. Sterno-costal elevation was adopted for 196 patients. Sternal turnover was employed for 11 adult patients with severe asymmetric deformities. In sterno-costal elevation, a section of the 3rd or 4th to the 7th costal cartilages were resected, and all of the cartilage stumps were resutured to the sternum. The secured ribs generate 0.5 to 12 kg of tension, pulling the sternum bilaterally, such that the resultant force causes the sternum to rise anteriorly and prevents flail chest. We've made modifications such as resection of the lower tip of the sternum below the 6th cartilage junction, or a diagonal groove on the sternal cortex to get better correction in any age group. There were neither operative death nor any severe complications, and in all cases the deformities were corrected satisfactorily. Patients resumed unlimited daily activities within 3 months after surgery. Our technique represents a less invasive procedure with low operative risk for the repair of pectus excavatum in any age group.