Results of pectus excavatum correction using a minimally invasive approach with subxyphoid incision and three-point
Sheldon J Bond1, Emily Rapstine2, Jordan M Bond2
1Department of Surgery, Division of Pediatric Surgery, University of Louisville, 315 E. Broadway, Ste 565, Louisville, KY, 40202, USA. sjbond01@louisville.edu.
Objectives:
This study reviews the results of our previously described modification of the minimally invasive (Nuss) procedure for correction of pectus excavatum. It utilizes a subxyphoid incision with central fixation to maximize safe bar passage and minimize bar displacement.
Methods:
Consecutive patients corrected with the modified Nuss procedure between 2010 and 2015 form the basis of this study.
Results:
During the study period, 73 patients had correction of their pectus excavatum by the modified Nuss procedure, utilizing subxyphoid incision and central fixation. Average age was 14.3 (range 8-19). 54 patients were male, 19 female. The average Haller index was 4.3 (range 3.2-7.2). No episodes of cardiac perforation, hemothorax or significant pneumothorax were recorded. Bar displacement occurred in two patients (2.7%) with one late recurrence after bar removal.
Conclusions:
Our modification of the Nuss procedure is effective at preventing intrathoracic complications and cardiac perforation. Central fixation had a lower rate of bar displacement compared to published reports. Additional efforts are needed to further reduce bar displacement.
