Comparison of the Nuss procedure for pectus excavatum by age and uncommon complications.
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.
Ohno
Koichi
K
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
Morotomi
Yoshiki
Y
Ueda
Masanao
M
Yamada
Hiroto
H
Shiokawa
Chizuka
C
Nakaoka
Tatsuo
T
Tsujimoto
Kasuke
K
Nakahira
Masashi
M
Moriuchi
Takayoshi
T
Harumoto
Ken
K
Yoshida
Tatsuyuki
T
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