title: Pleural effusion complicating after Nuss procedure for pectus excavatum.
abstract: OBJECTIVE
  The Nuss procedure is a minimally invasive method for the correction of pectus excavatum (PE). Pleural effusion complicating following the Nuss procedure was uncommon but may be critical. We evaluated the risk factors of postoperative pleural effusion after Nuss repair.
  
  
  METHODS
  We included all patients with PE primarily corrected by Nuss procedure from July 2005 to December 2011. The clinical features, treatment and outcomes of these patients with pleural effusion were analyzed retrospectively.
  
  
  RESULTS
  390 patients (338 men, 52 women) with a mean age of 23.9 years (5-44 years) were included. Postoperative pleural effusion occurred in 10 patients (2.6%). The time of occurrence of pleural effusion was on a mean of 16.6 days (8-32 days) after operation presenting with progressive dyspnea. All of these patients were adults, and 9 patients (90%) were repaired by two pectus bars (p <0.001). Six patients with massive pleural effusion received thoracocentesis (400 ml-1000 ml). All of the effusions were exudative. These patients took short-term indomethacin or steroids without removal of bars and all recovered well after a mean of 40 months (12-72 months) follow-up.
  
  
  CONCLUSIONS
  Pleural effusion complicating after Nuss procedure was uncommon. It occurred most on adult patients with placement of double bars. Close follow-up in adults after more than one bar insertion is recommended. Administration of temporary medications of indomethacin/steroid and/or thoracocentesis could obtain a satisfying result. Early administration of indomethacin/steroid in adult patients repaired by two bars with mild pleural effusion for preventing pooling of effusion could also be considered.
authors: Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Yeung-Leung
authors: YL
authors: Cheng
authors: Chin-Ta
authors: CT
authors: Lin
authors: Han-Bin
authors: HB
authors: Wang
authors: Huang
authors: H
authors: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005660:Funnel Chest / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects*; D019152:Paracentesis; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013256:Steroids