Repair of pectus excavatum deformities in children: a new perspective of treatment using minimal access surgical technique.
OBJECTIVE
Minimally invasive correction of pectus excavatum (PE) deformities of the anterior chest wall in children is safe and effective.


METHODS
Prospective cohort study.


METHODS
Tertiary pediatric referral center.


METHODS
Between February 1996 and July 2000, 36 patients underwent minimally invasive repair (MIR) of PE deformities, and 6 patients had traditional Ravitch repairs (RR).


METHODS
Morbidity, operating time, estimated blood loss, days to tolerating a regular diet, and length of hospital stay.


RESULTS
Thirty-six children underwent MIR for moderate to severe chest wall deformities, with a mean operative time of 1.6 hours, a mean blood loss of 22 mL, a mean time to tolerating a regular diet of 2.9 days, no intensive care unit admissions, and a mean length of hospital stay of 5.5 days. Six children had RR procedures performed for moderate to severe deformity, with a mean operative time of 5.2 hours, a mean blood loss of 222 mL, a mean time to tolerating a regular diet of 3.3 days, 2 patients admitted to the intensive care unit, and a mean length of hospital stay of 4.5 days. Complications for both procedures consisted mainly of postoperative pneumothorax.


CONCLUSIONS
The MIR technique for PE is less invasive, less morbid, and better tolerated than traditional open RR of this common pediatric chest wall deformity. Elective surgical reconstruction can be safely performed in children rather than limiting repair to only symptomatic patients with severe deformities.
Wu
P C
PC
Department of Surgery, University of Connecticut Health Center, Farmington, CT, USA.
Knauer
E M
EM
McGowan
G E
GE
Hight
D W
DW
D000293:Adolescent; D002648:Child; D005260:Female; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome