title: Minimally invasive repair of pectus excavatum (MIRPE) in adults: is it a proper choice?
abstract: BACKGROUND
  The Nuss procedure is suitable for prepubertal and early pubertal patients but can also be used in adult patients.
  
  
  OBJECTIVE
  To determine whether the minimally invasive technique (MIRPE) can also be performed successfully in adults.
  
  
  METHODS
  Between July 2006 and January 2016, 836 patients (744 male, 92 female) underwent correction of pectus excavatum with the MIRPE technique at our institution. The mean age was 16.8 years (2-45 years). There were 236 adult patients (28.2%) (> 18 years) - 20 female, 216 male. The mean age among the adult patients was 23.2 years (18-45 years). The recorded data included length of hospital stay, postoperative complications, number of bars used, duration of the surgical procedure and signs of pneumothorax on the postoperative chest X-ray.
  
  
  RESULTS
  The MIRPE was performed in 236 adult patients. The average operative time was 44.4 min (25-90 min). The median postoperative stay was 4.92 ±2.81 days (3-21 days) in adults and 4.64 ±1.58 (2-13) in younger patients. The difference was not statistically significant (p = 0.637). Two or more bars were used in 36 (15.8%) adult patients and in 44 (7.5%) younger patients. The difference was not statistically significant either (p = 0.068). Regarding the overall complications, complication rates among the adult patients and younger patients were 26.2% and 11.8% respectively. The difference was statistically significant (p = 0.007).
  
  
  CONCLUSIONS
  MIRPE is a feasible procedure that produces good long-term results in the treatment of pectus excavatum in adults.
authors.affiliation: Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Ezel
authors.initials: E
authors.lastname: Erşen
authors.affiliation: Department of Thoracic Surgery, School of Medicine, Istanbul Acıbadem University, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirkaya
authors.affiliation: Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Kılıç
authors.affiliation: Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Hasan Volkan
authors.initials: HV
authors.lastname: Kara
authors.affiliation: Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Yakşi
authors.affiliation: Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Nurlan
authors.initials: N
authors.lastname: Alizade
authors.affiliation: Department of Thoracic Surgery, Medical Faculty, Istanbul Bilim University, Istanbul, Turkey.
authors.forename: Özkan
authors.initials: Ö
authors.lastname: Demirhan
authors.affiliation: Department of Anesthesia and Reanimation, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Sayılgan
authors.affiliation: Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Akif
authors.initials: A
authors.lastname: Turna
authors.affiliation: Department of Thoracic Surgery, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Kaynak
keywords: Nuss; adult; excavatum; minimally invasive; pectus