Early results of 18 adults, following a modified Nuss operation for recurrent pectus excavatum

The minimally-invasive Nuss operation has been widely used for correcting pectus excavatum in children. However, a number of adult patients require reoperations for recurrence or other complications. This work aimed to investigate the early results of recurrent pectus excavatum repair using a modified Nuss procedure, which were seldom reported in adult patients.

A retrospective chart review was conducted on 18 adult patients who underwent modified Nuss procedure in the age range of 18-31 years. The Haller index of the patients ranged from 3.2 to 6.5. In the modified Nuss technique, a small auxiliary incision was made below the xiphoid process and one finger was inserted instead of a thoracoscope. The introducer was guided by the finger, slowly advanced across the mediastinum and raised the sternum and the anterior chest wall to the desired position. The Lorenz correction bar was introduced through the tunnel, placed in position, and turned over so that the convexity faced anteriorly.

The operations were performed successfully and no operative mortality occurred. The mean operating time was 68.5 ± 15.5 min. The postoperative results were excellent in 77.8% of patients and good in 22.2%. Early complications were mild and no late complications occurred.

The modified Nuss procedure is an excellent reoperative correction for adult patients and has outstanding early results, considering that it is technically challenging.