Is extra-pleura Nuss procedure more secure and effective?

Area of Science:

• Thoracic surgery
• Pediatric surgery
• Minimally invasive procedures

Background:

• Pectus excavatum is a congenital chest wall deformity requiring surgical correction.
• The Nuss procedure is a common surgical technique for pectus excavatum repair.
• Variations in the Nuss procedure aim to improve outcomes and reduce complications.

Purpose of the Study:

• To compare the total extra-pleural Nuss procedure with the classical Nuss procedure.
• To evaluate the efficacy and safety of the thoracoscopic total extra-pleural Nuss approach for pectus excavatum correction in children.

Main Methods:

• A retrospective study of 69 pediatric patients with pectus excavatum.
• Group A (40 patients): Thoracoscopic total extra-pleural Nuss procedure.
• Group B (29 patients): Classical Nuss procedure (intrapleural).

Main Results:

• Both procedures were successful with no intraoperative complications.
• Group A showed significantly shorter postoperative hospital stays (4.0 vs 5.2 days) and reduced pain duration (2.6 vs 4.1 days).
• Fewer complications like subcutaneous emphysema and pleural irritation were observed in Group A (0% vs 6.9%).

Conclusions:

• The thoracoscopic total extra-pleural Nuss procedure is safe and less traumatic for pectus excavatum correction.
• This approach offers advantages in postoperative recovery and pleural cavity protection.
• It results in fewer complications compared to intrapleural Nuss procedures.