Surgical treatment of pectus excavatum: 30 years 398 patients of experiences.
OBJECTIVE
The aim of the study is to review the surgical experiences with pectus excavatum (PE) chest deformities at the Department of Pediatric Surgery, West China Hospital of Sichuan University (Sichuan, PR China), during a 30-year period.


METHODS
Records of 398 PE patients (396 congenital, 2 acquired) who underwent surgical repair between 1975 and 2005 were reviewed. Modified sternal elevation was applied in all patients. Repair was performed with subperiosteal resection of the abnormal cartilages, transverse wedge osteotomy of the anterior sternum, and internal support with a metal strut for 1 year. Five technical details were strictly followed for each case. Three hundred twelve patients (78.39%) were followed up from 1 to 16 years.


RESULTS
There were no deaths. Normal contour of the costal cage was constructed postoperatively in 98.74% (393/398) of the patients. Exercise tolerance was improved, and cardiac function recovered to the healthy level of same age. But pulmonary function recovered slowly after surgery.


CONCLUSIONS
The 5 technical details are key principles for sternal elevation. Normal appearance of chest wall can be recovered; normal cardiopulmonary function can be restored by the modified sternal elevation with excellent long-term physiologic, cosmetic results and low rate of complications.
Hu
Ting-ze
TZ
Department of Pediatric Surgery, West China Hospital, Sichuan University, Sichuan 610041, PR China. liyuanletters@163.com
Li
Yuan
Y
Liu
Wen-ying
WY
Wu
Xue-dong
XD
Feng
Jie-Xiong
JX
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D005660:Funnel Chest / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male