title: Minimally invasive bar repair for 'redo' correction of pectus excavatum.
abstract: OBJECTIVE
  A small percentage of patients who have undergone traditional, "Ravitch-type" pectus excavatum repair present with unsatisfactory results and require a second procedure for correction. Reoperative open surgery for pectus excavatum has been associated with extensive dissection and substantial blood loss. The minimally invasive (MIS) bar repair for the correction of pectus excavatum has been gaining acceptance. This study evaluates the authors results with patients who have undergone the MIS bar repair for redo correction of their pectus excavatum.
  
  
  METHODS
  A retrospective chart review of all patients undergoing MIS bar repair between December 1997 and August 2001 was performed. Information about demographics, deformity, operative course, complications, and early outcome was recorded.
  
  
  RESULTS
  Ninety-two patients underwent MIS repair during this period. Ten patients had redo MIS bar repair for unsatisfactory prior open correction. Operating time was 52 minutes for standard patients and 70 minutes for the redo patients (P <.001). Blood loss and postoperative hospitalization were similar between groups.
  
  
  CONCLUSIONS
  The minimally invasive pectus repair can be performed safely with minimal blood loss and short operating time in patients who have undergone prior unsatisfactory open repair of pectus excavatum and can be an alternative approach to reoperative open repair in these patients.
authors.affiliation: Children's Mercy Hospital, University of Missouri at Kansas City School of Medicine, Kansas City, MO 66408, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Miller
authors.forename: D J
authors.initials: DJ
authors.lastname: Ostlie
authors.forename: K
authors.initials: K
authors.lastname: Wade
authors.forename: B
authors.initials: B
authors.lastname: Chaignaud
authors.forename: G K
authors.initials: GK
authors.lastname: Gittes
authors.forename: W M
authors.initials: WM
authors.lastname: Andrews
authors.forename: K W
authors.initials: KW
authors.lastname: Ashcraft
authors.forename: R J
authors.initials: RJ
authors.lastname: Sharp
authors.forename: C L
authors.initials: CL
authors.lastname: Snyder
authors.forename: G W
authors.initials: GW
authors.lastname: Holcomb
mesh_terms: D002648:Child; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome