title: Comparison of Postoperative Period in Patients with Pectus Excavatum Treated with Nuss Technique and Ravitch Technique.
abstract: BACKGROUND
  Pectus excavatum (PE) is the most common defect of the chest wall. Surgery for PE can be performed with an open or endoscopic technique. The choice of the surgical approach influences the postoperative course. The aim of the paper is to analyze the postoperative period in two groups of patients treated for PE. Group 1 consisted of patients who underwent endoscopic surgery, and Group 2 was composed of patients who underwent open surgery. A secondary aim is to compare the surgical outcomes between the two groups.
  
  
  METHODS
  The study group consisted of 40 patients treated in a single centre that uses a uniform postoperative analgesic protocol. The duration of surgery, blood loss, duration of hospital stay, complications, pain intensity and consumption of opioid and non-opioid analgesics were analyzed. The mean duration of follow-up was 9 months (6 -25 months).
  
  
  RESULTS
  Age at surgery, weight and height did not differ between the groups. In Group 1 the duration of surgery and blood loss were lower than in Group 2. In Group 1 complications occurred in 25% of the patients. Pain intensity was higher in Group 1 (4.23 vs. 3.67), as was the consumption of strong opioids (0.52 mg/kg body weight vs. 0.25 mg/kg body weight). Subjective evaluation was satisfactory in 85% of the patients in Group 1 and 90% in Group 2.
  
  
  CONCLUSIONS
  1. Both techniques led to a satisfactory outcome. 2. The duration of surgery and blood loss were higher in the open surgery group, but pain intensity and consumption of strong analgesics were higher among the patients treated with the endoscopic technique. 3. Preparation for surgery should involve planning appropriate analgesic treatment in the post-operative period.
authors.affiliation: Department of Orthopedics and Rehabilitation, Jagiellonian University Medical College, Zakopane, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Potaczek
authors.affiliation: Department of Orthopedics and Rehabilitation, Jagiellonian University Medical College, Zakopane, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Duda
authors.affiliation: Department of Orthopedics and Rehabilitation, Jagiellonian University Medical College, Zakopane, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Adamczyk
authors.affiliation: Department of Orthopedics and Rehabilitation, Jagiellonian University Medical College, Zakopane, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Jasiewicz
authors.affiliation: Department of Orthopedics and Rehabilitation, Jagiellonian University Medical College, Zakopane, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Tęsiorowski
authors.affiliation: Department of Orthopedics and Rehabilitation, Jagiellonian University Medical College, Zakopane, Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Daszkiewicz
mesh_terms: D000328:Adult; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000175:diagnosis* / Q000601:surgery*; D013502:General Surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome