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Complications of the "Nuss Procedure" In Pectus Excavatum
A Garzi1, M Prestipino2, M S Rubino1
1Division of Pediatric M.I.S. and Robotic Surgery University of Salerno, Italy.
Insights
The Nuss procedure is a common surgery for Pectus Excavatum (PE), a chest wall deformity. This study found that while complications occur, the Nuss technique remains effective for PE treatment, with no link between deformity severity and complications.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Deformities
Background:
- Pectus Excavatum (PE) is a frequent pediatric chest wall deformity.
- The Nuss procedure is the current standard surgical treatment for PE.
- Understanding complications is crucial for optimizing patient outcomes.
Purpose of the Study:
- To describe complications associated with the Nuss procedure for Pectus Excavatum.
- To analyze complication rates in relation to deformity symmetry and severity.
- To evaluate the overall efficacy and safety of the Nuss technique in a large pediatric cohort.
Main Methods:
- Retrospective analysis of 402 pediatric patients undergoing Nuss procedure between 2005 and 2018.
- Categorization of patients based on deformity symmetry (symmetric vs. asymmetric) and severity (mild, moderate, severe using Haller's index).
- Detailed recording and classification of intraoperative and post-operative complications.
Main Results:
- Overall complication rate was 20.39% (82/402 patients).
- Intraoperative complications occurred in 4.98% (20/402) and post-operative complications in 15.42% (62/402).
- No statistically significant correlation was found between PE symmetry or severity (Haller's index) and the occurrence of surgical complications.
Conclusions:
- The Nuss procedure is a safe and effective surgical treatment for Pectus Excavatum in pediatric patients.
- Complication rates are relatively low, and the Nuss technique is supported by current literature.
- Deformity characteristics like symmetry and severity do not appear to influence complication risk.
Abstract:
During the pediatric age range, one the most frequent deformities of the chest wall are Pectus Excavatum (PE). Currently the treatment of choice for PE is surgical intervention following the Nuss procedure. In this study, we present a description of the complications associated with surgical treatment of PE with the Nuss technique, in patients with symmetrical or asymmetrical deformity, in different stages of disease severity. The study was conducted in collaboration with the Pediatric Hospital "Istituto G. Gaslini" of Genoa. We analyzed a cohort of 402 patients (334 males and 68 females), who underwent corrective surgery between 2005 and 2018. Within this group of patients, we observed 82 cases with complications (20.39%), 20 of which were intraoperative (4.98%) and 62 post-operative (15.42%). For the evaluation of complications, this group was arbitrarily divided into patients with symmetric and asymmetric Pectus and in patients with mild, moderate and severe Pectus using Haller's index. Although a small group of patients presented complications, overall results from data analysis show that the Nuss technique represents the preferred surgical procedure for the treatment of PE, in agreement with literature. Furthermore, in our results show no correlation between asymmetry or severity of PE with complication related to the surgery.
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