title: Symmetrical excessive pectus excavatum in children.
abstract: OBJECTIVE
  The indications for repair of pectus excavatum are controversial. We present our surgical results in children with severe pectus excavatum.
  
  
  METHODS
  27 children aged 6-15-years were included in the study. Pulmonary function tests and chest measurements were performed pre- and postoperatively. Deformed cartilages were resected subperichondrially, and a Kirchner wire was used to support the chest cage; it was removed 5 days after the operation. Fourteen children with restricted pulmonary function were considered to have excessive pectus excavatum.
  
  
  RESULTS
  3 patients had asthma-like symptoms that resolved postoperatively. None suffered chest pain postoperatively. Postoperative hospital stay was 7.1 days. Only minor complications occurred postoperatively. The mean pectus severity index was 0.27 ± 0.2 preoperatively and 0.41 ± 0.1 postoperatively (p < 0.05). For children with restricted pulmonary function, it was 0.17 ± 0.3 preoperatively and 0.38 ± 0.2 postoperatively (p < 0.05). Mean percentage of predicted forced expiratory volume in 1 s changed significantly from 79.2% ± 17.8% preoperatively to 83.6% ± 12.2% by the 3rd postoperative month. For children with a pectus severity index <0.2, it changed from 68.5% ± 13.2% preoperatively to 82.3% ± 13.4%. Pulmonary restriction correlated with a worse pectus severity index (r = 0.8). After 6 and 13 months, a minor decrease in pulmonary function was noted. Significant increases in right and left ventricular function occurred in cases of severe deformity.
  
  
  CONCLUSIONS
  Surgery is recommended not only for cosmetic reasons but also to increase cardiorespiratory functional capacity and alleviate symptoms. Kirchner wires can be used safely.
authors.affiliation: Euphrates University School of Medicine, Department of Thoracic Surgery, Elaziğ, Turkey.
authors.forename: Akin Eraslan
authors.initials: AE
authors.lastname: Balci
authors.forename: Sevval
authors.initials: S
authors.lastname: Eren
authors.forename: Mehmet Oguzhan
authors.initials: MO
authors.lastname: Ozyurtkan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001864:Bone Wires; D002648:Child; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D005660:Funnel Chest / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008168:Lung / Q000503:physiopathology; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000295:instrumentation; D011183:Postoperative Complications / Q000209:etiology; D020127:Recovery of Function; D012086:Reoperation; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Bone wires; child; funnel chest; respiratory function tests; treatment outcome