A 20-year bibliometric analysis on the development trends and hotspots of pectus excavatum research: 2005-2025

Despite significant advances in surgical techniques for pectus excavatum (PE), the evolution of research priorities and clinical foci in this field remains poorly defined. This study aims to map the thematic evolution of PE research using bibliometric methods, thereby guiding future clinical research directions.

Publications on PE from 2005 to 2025 were retrieved from the Web of Science Core Collection (WoSCC). Bibliometric analyses, including co-authorship, co-citation, keyword co-occurrence, burst detection, and trend analyses, were conducted to evaluate research productivity, collaboration networks, and thematic shifts. Data visualization was conducted using CiteSpace, VOSviewer, and Scimago Graphica.

A total of 855 articles from 48 countries were included, demonstrating a steady increase in research output over the two decades. The United States, China, and South Korea were the primary contributors. The Catholic University of Korea, Children's Hospital of The King's Daughters, and Mayo Clinic were the leading institutions. Top authors by publication count included Hyung Joo Park, Robert E. Kelly Jr., and Michael J. Goretsky. Donald Nuss was the most highly cited author. The Journal of Pediatric Surgery was both the most productive and most frequently co-cited journal. Keyword analyses revealed that early research predominantly focused on surgical techniques, particularly the Nuss procedure, whereas recent trends have shifted toward postoperative pain management, intercostal nerve cryoablation, and outcome evaluation.

This bibliometric analysis delineates the developmental trajectory of PE research from 2005 to 2025, identifies emerging research hotspots, and highlights shifts in clinical foci. These findings may help guide the design of future clinical studies and foster collaborative efforts in the field.