HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ruy Fernando Kuenzer Caetano Silva Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by de Souza Coelho, M. Articles by de Matos Fernandes, L. Search for Related Content PubMed PubMed Citation Articles by de Souza Coelho, M. Articles by de Matos Fernandes, L. Related Collections Chest wall

---

Original Articles: General Thoracic

Pectus Excavatum Surgery: Sternochondroplasty Versus Nuss Procedure

Thoracic Surgical Department, Hospital Universitário Cajuru and Santa Casa de Misericórdia, Pontificial Catholic University of Paraná, Curitiba, Brazil

Accepted for publication July 28, 2009.

^_* Address correspondence to Dr de Souza Coelho, Rua Dep. Leoberto Leal, 187 Guabirotuba, Curitiba, Paraná, 81 510 090, Brazil (Email: clinicadotorax{at}marloscoelho.com.br).

Presented at the Poster Session of the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

Background: The repair of pectus excavatum (PE) by minimally invasive Nuss surgery is well established, but its complication rate is high and its indication is indiscriminate. Sternochondroplasty (SCP) provides good results with a low complication rate but requires a small transverse incision.

Methods: To compare SCP and Nuss, we analyzed 40 patients with PE who underwent surgery (SCP, n = 20; Nuss, n = 20). Thirty subjects (75.0%) were male and 10 (25.0%) were female. In the SCP group, 9 (45.0%) had symmetric PE, and 11 (55.0%) had asymmetric PE. In the Nuss group, 17 (85%) had symmetric PE, and 3 (15%) had asymmetric PE (p = 0.020).

Results: The mean duration of SCP was 229.5 minutes, and the mean duration of Nuss was 54.3 minutes. The average length of hospital stay was 4 days with SCP and 6.3 days with Nuss (p = 0.172). The SCP results were favorable in 18 subjects (90%) and fair in 2 subjects (10%). In the Nuss group, we observed 17 patients (85.0%) with favorable results and 3 (15.0%) with poor results. Patients with asymmetric PE exhibited severe pectus carinatum. No complications were found in 17 patients (85%) in the SCP group. In the Nuss group, 9 patients (45.0%) had 13 complications (65.0%; p = 0.004).

Conclusions: Sternochondroplasty surgery yielded better results than the Nuss procedure and more patients with asymmetric PE, less pain, and fewer complications. Nuss surgery had shorter operating times than SCP, younger patients, more symmetric PE, and 3 patients who experienced severe postoperative asymmetric pectus carinatum. In summary, for asymmetric PE the best indication is SCP.

This article has been cited by other articles:

				T. Nagasao, M. Noguchi, J. Miyamoto, H. Jiang, W. Ding, Y. Shimizu, and K. Kishi Dynamic effects of the Nuss procedure on the spine in asymmetric pectus excavatum J. Thorac. Cardiovasc. Surg., December 1, 2010; 140(6): 1294 - 1299.e1. [Abstract] [Full Text] [PDF]

				S. Evman and M. Yuksel Is Sternochondroplasty Really Superior to Nuss Procedure? Ann. Thorac. Surg., October 1, 2010; 90(4): 1397 - 1397. [Full Text] [PDF]

				M. d. S. Coelho Reply Ann. Thorac. Surg., October 1, 2010; 90(4): 1397 - 1397. [Full Text] [PDF]