Surgical Correction of Pectus Excavatum by the Nuss Procedure: A 15-Year Experience Study

Adv Exp Med Biol. 2018:1047:31-40. doi: 10.1007/5584_2017_121.

Abstract

Pectus excavatum is the most common congenital deformity of the chest. The Nuss procedure is minimally invasive surgical correction of this defect, using retrosternal metal bars. The purpose of the present study was to describe a 15-year experience with the Nuss surgery, and to evaluate the long-term clinical results of the procedure. We retrospectively evaluated 239 patients, aged 14-34, who underwent the Nuss surgery in the years 2002-2016. Postoperative complications were observed in 40/236 (16.9%) patients. The most common complication was pneumothorax in 14/239 patients. Less common were the following: wound infection in 4, pleural effusion in 3, allergy to nickel in 1, lung atelectasis in 1, and ventricular failure in 1 patient. Three patients were treated because of severe postoperative pain, and in one case the implant had to be removed. Postoperative complications associated with the number of bars inserted, but not with the patient age or gender. A satisfactory and long lasting corrective effect of surgery was observed in 231/239 (96.7%) of patients. There was no perioperative mortality. We conclude that the Nuss surgery is a safe surgery that demonstrates excellent and long-lasting esthetic results, with a low risk of severe complications.

Keywords: Chest wall; Congenital deformity; Nuss procedure; Pectus excavatum; Pneumothorax; Postoperative complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Funnel Chest / surgery*
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods*
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods*
  • Pneumothorax / etiology*
  • Postoperative Complications / etiology
  • Prostheses and Implants
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult