[The treatment of pectus excavatum: results of a mininvasive surgical technique on the first 50 patients].
OBJECTIVE
Pectus excavatum is the commonest thoracic congenital malformation, but its treatment remains not well known. The authors present the results of the mini-invasive repair at G. Gaslini Institute of Genoa, Italy.


METHODS
Nuss mini-invasive repair avoids anterior scars. The correction is achieved by the introduction under thoracoscopy of a retrosternal curve bar that is rotated by 180 degrees . Postoperatory pain is managed by an epidural catheter. In all the operated patients we evaluated the clinical pre-operatory parameters (spirometric, radiological and cardiological data), the surgical details and the results.


RESULTS
Fifty patients were operated, 43 of them males, ranging from 7 and 22 years of age, with an average of 17 years of age. Only 8 of them were asymptomatic and required surgery for psychological reasons. The 74% presented some stress dyspnea. Some impairment in spirometric parameters were observed in 28% and mitral valve prolapse in 30%. The only significant intra-operative complication was a bleeding from a thoracic wall vessel that required a left emergency minimal thoracotomy. Postoperative complications were: 2 pneumothorax (drained for 24 hours), 2 transitory pulmonary atelectasis, 1 hemothorax in a patient with coagulation deficit, 3 wound problems (1 infection and 2 hematomas). The esthetical score after surgery, according to the patients, was 9.15 on average, in a scale from 1 to 10. None rated less than 7. The pain score with the same scale was rated 6.8 on average.


CONCLUSIONS
The Nuss technique is safe and guarantees very satisfactory esthetical results.
Torre
M
M
Dipartimento di Chirurgia Pediatrica, Istituto Giannina Gaslini, Genova, Italia. micheletorre@hotmail.com
Mameli
L
L
Montobbio
G
G
Asquasciati
C
C
Campanella
V
V
Ferrari
C
C
Jasonni
V
V
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005660:Funnel Chest / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome