Pectus Arcuatum Definitions, Diagnostics, and Surgical Guidelines: A Systematic Review

Area of Science:

• Thoracic surgery
• Congenital anomalies
• Chest wall deformities

Background:

• Pectus arcuatum is a rare anterior chest wall deformity.
• It is often misdiagnosed as pectus excavatum, carinatum, or mixed deformities.
• A clear understanding of its clinical and physiological basis is needed for accurate diagnosis and management.

Purpose of the Study:

• To comprehensively review pectus arcuatum, including nomenclature, epidemiology, classification, pathophysiology, assessment, management, and surgical outcomes.
• To provide recommendations for clinical decision-making.
• To highlight the distinct nature of pectus arcuatum from other pectus deformities.

Main Methods:

• A systematic review of PubMed, Google Scholar, and reference lists was conducted.
• Searches were performed on February 2, 2025.
• Two independent reviewers screened articles, synthesizing data from 65 included studies representing 455 cases.

Main Results:

• Pectus arcuatum is a distinct rare variant of pectus deformities.
• Heterogeneity exists in nomenclature, epidemiology, associated conditions, assessments, management, and outcomes.
• Surgical repair, including open and hybrid minimally invasive techniques, yielded good postoperative outcomes.

Conclusions:

• Pectus arcuatum is a unique pectus deformity requiring clear terminology and diagnostic criteria for proper management.
• Minimally invasive hybrid approaches are refining surgical outcomes.
• Standardized approaches are crucial for improving diagnostic accuracy and management.