title: Surgical correction of 639 pectus excavatum cases via the Nuss procedure.
abstract: BACKGROUND
  To review the clinical experience and short- to middle-term effects of the Nuss procedure for correction of pectus excavatum (PE).
  
  
  METHODS
  From September 2006 to August 2014, 639 patients with PE were treated using the Nuss procedure. Of these, 546 were male and 93 were female. The mean age was 15.3±5.8 years (2.5-49 years). Preoperative chest CT scans Haller index (HI) was 4.3±1.7 (2.9-17.4), with 75 cases of mild PE (HI <3.2), 114 cases of moderate PE (HI 3.2-3.5), 393 cases of severe PE (HI 3.6-6.0), and 57 cases of extremely severe PE (HI >6.0).
  
  
  RESULTS
  A total of 638 patients successfully completed the surgery, an 11-year-old male patient who died after the surgery had undergone ventricular septal defect closure surgery through a sternal incision 7 years ago. The mean operative time was 64.3±41.7 min (40-310 min). Excluding the patient who died, the average blood loss was 24.5±17.8 mL (10-160 mL). The average length of postoperative hospital stay was 5.2±2.9 days (4-36 days). A total of 484 cases (75.7%) required 1 steel bar insertion, 153 cases (24.0%) required 2 steel bars, and 2 cases (0.3%) required 3 bars. Postoperative evaluation of the surgery outcomes revealed the following: excellent in 504 cases, good in 105, fair in 28 and poor in 2, good quality rate was 95.3%.
  
  
  CONCLUSIONS
  Correction of PE via the Nuss procedure is minimally invasive and simple to perform with good short and mid-term effects, while long-term efficacy remains to be determined.
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Dong-Kun
authors.initials: DK
authors.lastname: Zhang
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Ji-Ming
authors.initials: JM
authors.lastname: Tang
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Xiao-Song
authors.initials: XS
authors.lastname: Ben
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xie
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Hai-Yu
authors.initials: HY
authors.lastname: Zhou
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Xiong
authors.initials: X
authors.lastname: Ye
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Zi-Hao
authors.initials: ZH
authors.lastname: Zhou
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Rui-Qing
authors.initials: RQ
authors.lastname: Shi
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Pu
authors.initials: P
authors.lastname: Xiao
authors.affiliation: 1 Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China ; 2 Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
keywords: Pectus excavatum/surgery (PE/surgery); minimally invasive