title: Comparison of the Nuss procedure for pectus excavatum by age and uncommon complications.
abstract: BACKGROUND
  We summarized our experience of the Nuss procedure for pectus excavatum with comparison by age and uncommon complications.
  
  
  METHODS
  Twenty-three patients underwent the Nuss procedure. Their age ranged from 3 to 19 years old. The outcome was compared between two groups divided by age: teenagers (> or = 13 yrs old, n = 5, Group 1) and younger patients (n = 18, Group 2).
  
  
  RESULTS
  Cosmetic results were significantly better, and the operating time and postoperative hospital stay in Group 2 were significantly shorter than in Group 1. Complications were more frequently seen in Group 1 than in Group 2. In all three younger patients whose bars were removed after 2 years, the ribs holding the bar were deformed. Uncommon complications occurred in two cases. In one case, pneumothorax occurred due to laceration by a fragment of wire after 12 months, and the fragment fell into the thoracic cavity. In another case, pneumothorax occurred due to injury by the port of a thin thoracoscope.
  
  
  CONCLUSIONS
  The teenaged patients had more complications and poorer cosmetic results. Therefore, this operation should be performed before the teenage years. In younger patients with rapid growth, the bar should be removed less than 2 years to prevent restriction of costal growth.
authors.affiliation: Department of Pediatric Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. m4531173@msic.med.osaka-cu.ac.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohno
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Morotomi
authors.forename: Masanao
authors.initials: M
authors.lastname: Ueda
authors.forename: Hiroto
authors.initials: H
authors.lastname: Yamada
authors.forename: Chizuka
authors.initials: C
authors.lastname: Shiokawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakaoka
authors.forename: Kasuke
authors.initials: K
authors.lastname: Tsujimoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Nakahira
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Moriuchi
authors.forename: Ken
authors.initials: K
authors.lastname: Harumoto
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Yoshida
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome