title: Nonprosthetic surgical repair of pectus excavatum.
abstract: BACKGROUND
  Previously, a method was reported to correct pectus excavatum in which a convex steel bar is inserted beneath the sternum. This method gained popularity, but a relatively high incidence of complications has been reported. We review our experience of nonprosthetic repairs of pectus excavatum.
  
  
  METHODS
  From 1993 through 2004, 62 patients underwent repair of pectus excavatum. Sternocostal elevation was adopted for 54 patients (11.7 +/- 8.3 years old). A part of the third or fourth to the seventh costal cartilages was resected. All of the stumps were pulled to generate tension and resutured with the sternum. Cortical osteotomy of upper sternum and introduction of exogenous material were not employed. Sternal turnover and overlap was adopted for 8 adults (24.1 +/- 9.0 years old) with severe asymmetric deformities. The sternum was cut at the level of the second or third intercostal space. The lower part of the sternum was turned over and secured in a position so that it overlapped with the upper sternum, and the stumps of cartilages were reattached to the plastron. In these procedures, the natural tension exerted by the patient's ribs is sufficient to elevate and fix the sternum.
  
  
  RESULTS
  Mechanical ventilation was not required after emergence from anesthesia. None of the patients experienced threatening complications or required reoperation. Fifty patients (81%) were graded as excellent, and 12 patients (19%) were graded as good at 1 month after surgery.
  
  
  CONCLUSIONS
  The procedures described here yielded excellent results with low morbidity and no mortality, and produced high patient satisfaction.
authors.affiliation: Department of Cardiovascular Surgery, Kimitsu Central Hospital, Sakurai Kisarazu, Japan. iidahomburg@hotmail.com
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sudo
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamada
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsushita
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Eda
authors.forename: Yuho
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D013249:Sternum / Q000601:surgery; D019616:Thoracic Surgical Procedures / Q000009:adverse effects / Q000379:methods*