Pulmonary function, exercise capacity and dyspnea in patients 7 ​years after Nuss surgery

Area of Science:

• Thoracic surgery
• Pulmonary medicine
• Pediatric surgery

Background:

• Pectus excavatum is a common chest malformation.
• Minimally invasive repair of pectus excavatum (MIRPE) is increasingly used for cardio-respiratory and aesthetic reasons.
• Potential long-term effects of MIRPE on thoracic development and function are not fully understood.

Purpose of the Study:

• To evaluate long-term thoracic cage development, cardio-respiratory function, exercise capacity, and asymptomatic functioning in teenagers after MIRPE.
• To determine if MIRPE impacts lung development and function.

Main Methods:

• A cohort of 55 patients who underwent MIRPE between 2000 and 2010 were assessed.
• Matched controls were used for comparison.
• Pulmonary function tests (spirometry, body plethysmography, diffusion capacity) and the 6-minute walking test (6MWT) were performed. Chest diameters were measured.

Main Results:

• Patients who underwent MIRPE demonstrated normal pulmonary function and exercise capacity.
• The MIRPE group had lower BMI and anteroposterior chest diameter.
• Increased residual volume (RV%) and RV% total lung capacity (TLC), along with higher FEV1/FVC ratio and 6MWT distance, were observed.

Conclusions:

• Young adults who have undergone MIRPE can expect normal pulmonary function and exercise capacity.
• Observed air trapping warrants further investigation regarding the risk of emphysema development.
• MIRPE appears safe for long-term thoracic and respiratory health.