OBJECTIVETo review the experience in correction operation of pectus excavatum with non-thoracoscopic Nuss procedure.

METHODSFrom September 2005 to August 2007, 108 patients with pectus excavatum were surgically corrected by non-thoracoscopic Nuss procedure. There were 91 male patients and 17 female patients. The age was from 2 years and 10 months old to 25 years old with an average of 7 years and 9 months old. The Haller indexes were from 3.6 to 10.1 before the operation.

RESULTSThe operation in all patients had been performed successfully without any severe complications. The average time of operation was 40 minutes. The average bleeding volume during procedure was 10 ml. Uneventful recovery was achieved in all the cases. Excellent outcome was obtained in the follow-up of 2 months to 21 months in 92 patients.

CONCLUSIONSNon-thoracoscopic Nuss procedure for correction of pectus excavatum is safe and effective. It is unnecessary to perform the procedure into thoracic cavity so that there is less trauma and shorter time for the operation.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Funnel Chest ; diagnostic imaging ; surgery ; Humans ; Male ; Radiography ; Thoracic Surgical Procedures ; methods ; Treatment Outcome

PURPOSE: The aim of this study was to evaluate new cardiac deformity indexes (CDIs) for diagnosis of pectus excavatum as well as morphological assessment of heart on computed tomography (CT). MATERIALS AND METHODS: We retrospectively evaluated the CT images of the control group (n=200), and the pectus excavatum before and after correction groups (n=178), and calculated the CDIs; cardiac compression index (CCI), and cardiac asymmetry index (CAI). We also calculated chest wall compression index (CWCI) and asymmetry index (CWAI) on the axial images. We performed logistic regression analysis using each index and age as predictor variables. RESULTS: The CDIs (CCI and CAI) were significant (p < 0.05) in the diagnosis of pectus excavatum, regardless of age (p = 0.4033, p = 0.8113). The CWCI and CWAI were significant (p < 0.05) and significantly affected by age (p < 0.05). If we selected 1.82 as the cutoff of the CCI, the sensitivity and specificity were 99.4% and 98%, respectively. The following cutoffs and the sensitivity and specificity were obtained: 1.15 for the CAI gave 94.4% and 94.5%, 3.05 for the CWCI gave 92.1% and 92%, and 1 for the CWAI gave 62.4% and 65%, respectively. The CCI after repair improved from 2.83 +/- 0.84 to 1.84 +/- 0.33, while the CWCI improved from 4.49 +/- 1.61 to 2.57 +/- 0.44. CONCLUSION: CDIs such as the CCI and CAI may be potentially useful to detect and estimate repair for pectus excavatum.
Adolescent ; Age Factors ; Child ; Child, Preschool ; Female ; Funnel Chest/*radiography ; Heart Defects, Congenital/*radiography ; Humans ; Logistic Models ; Male ; Postoperative Period ; Retrospective Studies ; Tomography, X-Ray Computed/*methods ; Young Adult