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Changes in resting pulmonary function testing over time after the Nuss procedure: A systematic review and
Quan Wang1, Shulei Fan2, Chun Wu1
1Cardiothoracic surgery of Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; China international Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Journal of Pediatric Surgery
|March 19, 2018
Summary
The Nuss procedure for pectus excavatum initially depresses pulmonary function, but forced expiratory volume in 1s (FEV1) slightly improves at two years post-surgery. Further long-term studies are needed to confirm full recovery of lung function.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Pectus excavatum is a common congenital chest wall deformity in children.
- It often leads to impaired pulmonary function.
- The effectiveness of the Nuss procedure in restoring lung function remains debated.
Purpose of the Study:
- To evaluate changes in pulmonary function after the Nuss procedure.
- To analyze the impact of the Nuss procedure on lung function in pediatric patients.
Main Methods:
- Systematic literature search of MEDLINE, Embase, Cochrane, and PubMed.
- Included studies with pre- and post-operative pulmonary function tests (PFTs).
- Analyzed forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC); subgroup analyses by time and age.
Main Results:
- 13 studies with 465 participants were analyzed.
- Post-surgery FEV1 showed a slight increase (SMD 0.17, p=0.04), while FVC showed a non-significant decrease (SMD -0.18, p=0.14).
- A temporal relationship was observed, with FEV1 higher more than 2 years post-surgery (SMD 0.26, p=0.012).
Conclusions:
- The Nuss procedure initially depresses pulmonary function.
- FEV1 shows a slight improvement at two years post-surgery compared to baseline.
- Longer follow-up studies are necessary to determine if pulmonary function normalizes.
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