Surgical Treatment for Pectus Excavatum

Abstract

The aim of this study was to compare clinical outcomes in pectus excavatum patients undergoing a Ravitch operation with those undergoing a Nuss procedure. Retrospective study was conducted on one hundred and twenty three patients who underwent Ravitch operation (n=16) and Nuss procedure (n=107) between 1995 and 2002. Mean age of the patients was 7.9+/-6.2 yr. In the Ravitch group, operation time was 196.9+/-61.0 min, and required 10.2+/-2.6 chondral bone resections. Average hospital stay time was 15.9 days. In the Nuss group, operation time was 67.2+/-33.1 min, and bar removal was required two years after the bar insertion. The length of hospital stay was averagely 8.0 days, and postoperative reoperations were performed in five patients due to bar displacements, while early bar removal was required in one patient. The patient interviews for operation results were conducted and revealed that 92.3% of the patients in the Ravitch group showed good to excellent, while 93.3% of Nuss bar removed patients replied good to excellent. Though Nuss procedure has many advantages, it also has some disadvantages. So, the method of the operation should be selected according to the characteristics of the patient.

Ravitch versus Nuss procedure for pectus excavatum: systematic review and meta-analysis

“…Manual search of reference lists did not yield any new studies. After applying the selection criteria, 13 comparative studies (6,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) were finally included for analysis, including 10 studies with pediatric population, two studies on adult patients (20,21), and one study (19) with a mixed pediatric and adult population ( Figure 1). Studies with adult patients were required to have an average age of 20 or greater; however, as this was a mean, these studies still likely reported some pediatric cases.…”

Nuss procedure for Pectus excavatum repair: critical appraisal of the evidence

“…The bias risk assessment showed that all studies had a low risk of bias [13][14][15][16][17][18][19][20][21] (Table 1). Studies have failed mainly on comparability between cases and controls and confirmation of the absence of the outcome at baseline.…”

“…The use of different instruments to measure postoperative pain [13][14][15][16][17][18][19][20] and patient satisfaction 13,15,20 prevented these outcomes to be objectively evaluated. of the exposed of the exposed of the exposed of the exposed of the exposed the exposed the exposed the exposed the exposed the exposed Does not specify whether the outcomes are absent at the beginning of the study or if patients have previously been through the operative process.…”

The Nuss Procedure for the Correction of Pectus Excavatum

“…The age range of the patients who were qualified to the operation is wide in the literature, from 2 to 18 years (4,43). Adults are also operated (13,44).…”

“…The children with chest The results of the operation justify its wide application. The authors who compare Nuss and classic Ravitch procedure omit a very important aspect: a very exposed scar on the from wall of the chest versus two 2-3 cm scars in the axillary region (41,43) (fig. 5, 6).…”