title: Analysis of the Nuss procedure for pectus excavatum in different age groups.
abstract: 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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Daejeon.
authors.forename: Do Hyung
authors.initials: DH
authors.lastname: Kim
authors.forename: Jung Joo
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Mi Kyeong
authors.initials: MK
authors.lastname: Lee
authors.forename: Doo Yun
authors.initials: DY
authors.lastname: Lee
authors.forename: Hyo Chae
authors.initials: HC
authors.lastname: Paik
mesh_terms: 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