Introduction. Nuss procedure is a minimal invasive surgical technique based
on retrosternal placement of a metal plate to correct pectus excavatum chest
deformity. We are presenting our five?year (2006?2011) institutional
experience of 21 patients. Objective. The aim of this study was to determine
characteristics and advantages of minimal invasive surgical approach in
correcting deformities of the chest. Methods. Surgical procedure, named after
its author Nuss, involves the surgical placement of a molded metal plate, the
so?called pectus bar, behind the sternum under thoracoscopic view whereby
immediate controlled intraoperative corrections and stabilizations of the
depression can be made. The great advantage of this method is reflected in a
significant shortening of operative time, usually without indications for
compensation in blood volume, and with a significantly shortened
postoperative recovery that allows patients to quickly return to their normal
activities. Results. In the period 2006?2011, 21 patients were operated by
the Nuss procedure. The pectus bar was set in front or behind the muscles of
the chest. Among the complications listed were inflammation of wounds in
three patients, dislocation (shifting) of the bar requiring a reoperation in
two patients, an occurrence of a pericardial effusion in one patient, and
allergic response to foreign body in one patient. Five patients required
extraction of the bar two years later, and three patients after three years,
all with excellent results. Conclusion. Minimally invasive Nuss procedure is
safe and effective. It currently represents the primary method of choice for
solving the chest deformity pectus excavatum for patients of all ages.
Modification of thoracoscopic control allows a safe field of operation.
Postoperative results are excellent with very few complications that can be
attributed to the learning curve.
Evolving Management of Pectus Excavatum Based on a Single Institutional Experience of 664 Patients
