title: Experience with the Nuss technique for the treatment of Pectus Excavatum in Spanish Thoracic Surgery Departments.
abstract: BACKGROUND
  Although the Nuss technique revolutionized the surgical treatment of pectus excavatum, its use has not become widespread in our country. The aim of this study was to analyze the current use of this technique in a sample of Thoracic Surgery Departments in Spain.
  
  
  METHODS
  Observational rectrospective multicentric study analyzing the main epidemiological aspects and clinical results of ten years experience using the Nuss technique.
  
  
  RESULTS
  Between 2001 and 2010 a total of 149 patients were operated on (mean age 21.2 years), 74% male. Initial aesthetic results were excellent or good in 93.2%, mild in 4.1% and bad in 2.7%. After initial surgery there were complications in 45 patients (30.6%). The most frequent were wound seroma, bar displacement, stabilizer break, pneumothorax, haemothorax, wound infection, pneumonia, pericarditis and cardiac tamponade that required urgent bar removal. Postoperative pain appeared in all patients. In 3 cases (2%) it was so intense that it required bar removal. After a mean follow-up of 39.2 months, bar removal had been performed in 72 patients (49%), being difficult in 5 cases (7%). After a 1.6 year follow-up period good results persisted in 145 patients (98.7%).
  
  
  CONCLUSIONS
  Nuss technique in adults has had good results in Spanish Thoracic Surgery Departments, however its use has not been generalized. The risk of complications must be taken into account and its indication must be properly evaluated. The possibility of previous conservative treatment is being analyzed in several departments at present.
authors.affiliation: Cirugía Torácica, Hospital Universitari Sagrat Cor, Barcelona, España. Electronic address: juanjofibla@gmail.com.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Fibla
authors.affiliation: Cirugía Torácica, Hospital Universitari Sagrat Cor, Barcelona, España; Cirugía Torácica, Hospital Clinic, Barcelona, España.
authors.forename: Laureano
authors.initials: L
authors.lastname: Molins
authors.affiliation: Cirugía Torácica, Hospital Puerta de Hierro, Majadahonda (Madrid), España.
authors.forename: Javier
authors.initials: J
authors.lastname: Moradiellos
authors.affiliation: Cirugía Torácica, Hospital Insular de Las Palmas de Gran Canaria, Las Palmas, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Rodríguez
authors.affiliation: Cirugía Torácica, Hospital Clínico Universitario, Valladolid, España.
authors.forename: Félix
authors.initials: F
authors.lastname: Heras
authors.affiliation: Cirugía Torácica, Hospital Universitari Joan XXIII, Tarragona, España.
authors.forename: Emili
authors.initials: E
authors.lastname: Canalis
authors.affiliation: Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, España.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bolufer
authors.affiliation: Cirugía Torácica, Hospital Miguel Servet, Zaragoza, España.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez
authors.affiliation: Cirugía Torácica, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Aragón
authors.affiliation: Cirugía Torácica, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: Andrés
authors.initials: A
authors.lastname: Arroyo
authors.affiliation: Cirugía Torácica, Hospital Germans Trias i Pujol, Badalona, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Pérez
authors.affiliation: Cirugía Torácica, Complejo Hospitalario Universitario, Albacete, España.
authors.forename: Pablo
authors.initials: P
authors.lastname: León
authors.affiliation: Cirugía Torácica, Hospital Vall d́Hebrón, Barcelona, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Canela
mesh_terms: D005260:Female; D005660:Funnel Chest; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011030:Pneumothorax / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D013030:Spain; D013903:Thoracic Surgery; D055815:Young Adult
keywords: Chest wall deformities; Cirugía videotoracoscópica; Deformidades de pared torácica; Nuss technique; Pectus excavatum; Thoracoscopic surgery; Técnica de Nuss