Analysis of the Nuss procedure for pectus excavatum in different age groups.
BACKGROUND
The Nuss procedure is a newly developed operative method for minimally invasive repair of pectus excavatum in pediatric patients. However, the surgical indication for this procedure has been extended into adult patients. The aim of this study was to assess the surgical outcome of the Nuss procedure in different age groups and to analyze its feasibility in the adult population.


METHODS
From December 1999 to March 2003, 51 patients (40 males and 11 females) with pectus excavatum underwent the Nuss procedure. We classified patients into three groups based on age (pediatric, adolescent, and adult), retrospectively analyzed demographic, intraoperative and postoperative data, and compared outcomes among each group.


RESULTS
Mean operation time was 52.0 +/- 22.9 minutes, 80.4 +/- 27.4 minutes, and 127.3 +/- 44.9 minutes in the pediatric, adolescent, and adult groups, respectively (p < 0.001). Postoperative complications occurred in 3 of 27 patients (11.1%) in the pediatric group and in 7 of 12 patients (58.3%) in both the adolescent and adult groups (p = 0.002). Reoperations were performed due to complications in 1 of 27 patients (3.7%) in the pediatric group, 2 of 12 patients (16.6%) in the adolescent group, and 5 of 12 patients (41.7%) in the adult group (p = 0.001).


CONCLUSIONS
The Nuss procedure is highly recommended in pediatric patients with pectus excavatum. However, in adults it is necessary to select patients carefully because of the longer operation time and higher incidence of complications associated with the procedure in this population.
Kim
Do Hyung
DH
Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Daejeon.
Hwang
Jung Joo
JJ
Lee
Mi Kyeong
MK
Lee
Doo Yun
DY
Paik
Hyo Chae
HC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D007723:Korea / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D019616:Thoracic Surgical Procedures / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome