V-199 Modified Nuss technique in pectus excavatum: a mono-institutional experience of 13 Years.

Hintergrund

Pectus excavatum (PE) is the most common anomaly of the anterior chest wall (1:300-400). Prior PE was corrected by a modified Ravitch operation, but since Nuss published his minimal technique in 1998, most surgeons have preferred this technique.

 

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Material und Methode

Since 2008 a modified Nuss procedure has been used for PE-correction at our Thoracic Surgery Department. Between 2008 and 2021, 530 PE-Patients were evaluated and only 164 (30%) Patients have been corrected. The median age was 21.2±6.6 Years. All patients had preoperatively a „PCA“-epidural catheter. The postoperative pain treatment was planned for 4-5 weeks. The patients were routinely seen at 2 weeks, 6 months and then once yearly after surgery. The bars were removed after 4.7±2.96 years.

 

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Ergebnis

75 (45.7%) Patients had one bar, 84 (51.2%) Patients had two bars inserted, 5 (3%) Patients had three bars. The median length of the bar was 13±2 inch. Operation time was 80±25 Minutes. The median postoperative stay was 7±4.5 days. No death or deep infection occurred. 28 (17%) Patients experienced a complication.

 

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Schlussfolgerung

Due to the restrictive German health insurance regulations only a low number of PE-Patients received a surgical correction.

The Modified Nuss procedure is the treatment of Choice for PE. Short Bars should be used in order to achieve best stability, to obtain a good cosmetic result, reduced dysfunction motion of the chest wall and reduce the complication ratio. During the Time we used multiple and shorter Bars.

 

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Publication History

Article published online:
06 September 2021