[Nuss procedure by thoracoscopy for minimally invasive correction of pectus excavatum]

To summarize the effectiveness of Nuss procedure by thoracoscopy for correction of pectus excavatum.

Between September 2009 and January 2012, 33 patients suffering from pectus excavatum underwent Nuss procedure by thoracoscopy. There were 26 males and 7 females, aged from 3 to 22 years (median, 9 years). There was primary operation in 32 cases and reoperation in 1 case after Ravitch procedure. Twenty-four patients had obvious clinical symptoms. The Haller index ranged from 3.3 to 50.1 (mean, 5.6). According to simplified Park classification, 25 cases were classified as symmetric type, 5 as eccentric type, and 3 as unbalanced type.

Intercostal muscle tear occurred in 1 case during operation; pleural effusion, pulmonary infection, and thoracic vertebral pain occurred in 1 case, respectively after operation. The operation time ranged from 38 to 89 minutes (mean, 60.9 minutes). The intraoperative blood loss was 8-90 mL (mean, 26.2 mL). The postoperative hospitalization days were 6-12 days (mean, 7.6 days). All patients were followed up 12-39 months (mean, 25.6 months). Electrocardiogram and chest X-ray film showed that cardiac compression was improved, and symptoms alleviated. At the last follow-up, according to the Nuss standard, the results were excellent in 27 cases, good in 3 cases, and fair in 3 cases, with an excellent and good rate of 90.9%. There was no significant difference in results of effectiveness evaluation among less than 6 years, 6-12 years, and more than 12 years groups (Z= -1.751, P=0.109).

Nuss procedure by thoracoscopy has the advantages of little trauma, simple operation, and fast recovery, so it can obtain satisfactory correction of pectus excavatum.