Modified Nuss Procedure for Pectus Excavatum on Pediatric Patients

Objective To summarize the early experience of modified Nuss procedure with thoracoscope for repairing pectus excavatum in children.Methods Fifty-three pediatric pectus excavatum were treated by modified Nuss procedure with thoracoscope from June 2004 to July 2006,the age ranged from 2.4 to 16.0 years,the average age was 8.1 years.Thirty-six patients were symmetric pectus excavatum and 17 patients were asymmetric pectus excavatum.Results The operation in all patients were successful,the average blood loss was less than 10ml.Pericardium perforation occurred in 2 earlier patients during the operation,pneumothorax occurred in 6 patients postoperatively,pleural effusion occurred in 3 patients,and all resolved by corresponding treatments.The average hospital length of stay was 5.5 days.All patients had a satisfied deformity correction and no needs of transfusion.The depression was thoroughly corrected in 48 patients,residual depression was less than 20% of preoperative degrees in 5 patients.Therapeutic results evaluation showed excellent in 46 patients and good in 7 patients.All patients were followed up in 1-25 months without any complaints,the activity ability was same as normal children;there were no bar displacement and injury event occurred.The bar had been removed in 1 patient 24 months after surgery who still kept in excellent results.Conclusion Modified Nuss procedure is easy to be performed with minimal invasion and good short-term results.Thoracoscopic visualization facilitates the safety of this technique.It is recommendable to be tried and extended applied.