Open Access
CC BY 4.0 · Indian J Plast Surg 2025; 58(S 01): S5-S148
DOI: 10.1055/s-0045-1813508
Conference Abstracts

Beneath the Sternum: Correcting the Collapse in Pectus Excavatum—Our Surgical Technique and Outcomes

Classification of Study: Case Series

Authors

  • Aashita Yande

    1   Manipal Hospital, Hal Old Airport Road, Bengaluru, Karnataka, India

  • Y. N. Anantheswar

    1   Manipal Hospital, Hal Old Airport Road, Bengaluru, Karnataka, India

  • V. Srikanth

    1   Manipal Hospital, Hal Old Airport Road, Bengaluru, Karnataka, India

  • Mayur Shetty

    1   Manipal Hospital, Hal Old Airport Road, Bengaluru, Karnataka, India
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Correspondence: Aashita Yande (E-mail: aashyande@gmail.com)

Abstract

Background Pectus excavatum (“funnel chest”) is the most common congenital chest wall deformity, marked by posterior depression of the sternum and costal cartilages. Its severity ranges from a cosmetic concern to significant cardiopulmonary compromise.

Methodology Eight patients with pectus excavatum underwent surgical correction between 2022 and 2024. Three cases were idiopathic, while five were associated with Marfan syndrome. Preoperative evaluation included chest X-ray, pulmonary function tests (PFTs), echocardiography, and contrast-enhanced chest CT with 3D reconstruction. Surgery was performed via midline sternotomy. The pectoralis major muscles were elevated, and subperichondrial resection of costal cartilages (ribs: 3–6) was done, preserving the perichondrium. A retrosternal space was created, the xiphoid process excised, and an anterior wedge osteotomy (greenstick fracture) was performed between the second and third costal cartilages. The sternum was elevated with controlled pressure. Titanium reconstruction plates and steel wire sutures provided stabilization.

Results All patients underwent successful correction without intraoperative complications. The mean Haller Index improved from a mean of 4.2 to 2.8 at 1 month. Patient-reported outcomes using the Pectus Excavatum Evaluation Questionnaire (PEEQ) showed significant improvement in physical function, appearance-related self-esteem, and activity tolerance. PFTs showed modest improvement in FVC and FEV1 postoperatively. Minor complications included one seroma and one superficial wound dehiscence, managed conservatively.

Conclusion This tailored open surgical technique effectively corrects chest wall deformity while preserving growth potential. Favorable cosmetic and functional outcomes were observed in both idiopathic and syndromic cases, supporting its use in patients with moderate to severe pectus excavatum.

Keywords: open pectus repair, costal cartilage resection, wedge osteotomy, plate fixation, PEEQ improvement



Publication History

Article published online:
10 November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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