The nuss procedure – minimally invasive repair of pectus excavatum – a single center experience

Background: The Nuss Procedure, a minimally invasive repair of pectus excavatum (MIRPE), is the treatment of choice in children. It is currently introduced in adult surgery. We use the Nuss Procedure at our institution routinely since 2003. Methods: A retrospective review was performed on 32 patients who underwent MIRPE between January 2003 and August 2009. Information about demographics, complications, time of hospitalisation, analgesia and late outcome at pectus bar removal (PBR) were recorded. Results: At Jena University Hospital, MIRPE was used in 32 patients. 10 patients were treated at the Department of Cardiothoracic Surgery, 22 patients at the Paediatric Surgical Department. 15 patients (47%) were aged 16 years or older, mean patient age was 16.4 years (SD 3.6 range 6 to 26 years). Mean time of hospitalisation was 6.6 days (SD 2.6 range 3 to 15 days). On average pectus bars were removed after 2.7 years (SD 1.4 range 0 to 4.7 years). 4 Patients had preliminary PBR after dislocation or wound infection. Bilateral pneumothorax requiring chest tube insertion occurred once. Adequate analgesia could be performed via peridural catheter in 63%. All patients with scheduled PBR showed excellent aesthetic results. Conclusion: MIRPE can be safely performed and is the treatment of choice for young adults and children. It can be done with short hospitalisation time, reliable analgesia and excellent results with low complication rates. Although no life threatening complications were observed, as elsewhere reported, we would recommend a cooperation between cardiothoracic and paediatric surgeons.