Pulmonary function in children with Pectus excavatum and post-operative changes after nuss procedure

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Pulmonary Function Testing

Background:

• Pectus excavatum (PE) is a congenital chest wall deformity affecting pulmonary function.
• The Nuss procedure is a minimally invasive surgical technique for PE correction.
• Assessing post-operative pulmonary function is crucial for evaluating surgical outcomes in pediatric PE patients.

Purpose of the Study:

• To compare pulmonary function in children with mild versus severe pectus excavatum (PE).
• To evaluate post-operative changes in predicted vital capacity (%VC) after the Nuss procedure.
• To determine the impact of age on pulmonary function recovery following PE correction.

Main Methods:

• Retrospective analysis of 124 children who underwent the Nuss procedure for PE.
• Spirometry performed pre-operatively, pre-bar removal, and at 1 month and 1 year post-bar removal.
• Children stratified by Haller Index (HI) into mild (n=54) and severe (n=43) groups; age-based groups also analyzed.

Main Results:

• The severe PE group exhibited significantly lower %VC and peak expiratory flow rate than the mild group.
• Post-bar removal %VC changes were significantly lower in children aged 11 and over.
• A significant increase in %VC was observed 1 year after bar removal in children aged 10 and under.

Conclusions:

• The Nuss procedure offers significant pulmonary function benefits for children with pectus excavatum.
• Younger children (≤10 years) demonstrate a notable advantage in post-operative pulmonary function recovery.
• Surgical correction of PE via the Nuss procedure positively impacts long-term lung function in pediatric patients.