Nuss procedure for repair of pectus excavatum after failed Ravitch procedure in adults: indications and caveats.

Kocher, Gregor; Gstrein, Nathalie; Jaroszewski, Dawn E; Ewais, Mennatallah M; Schmid, Ralph (2016). Nuss procedure for repair of pectus excavatum after failed Ravitch procedure in adults: indications and caveats. Journal of thoracic disease, 8(8), pp. 1981-1985. Pioneer Bioscience Publishing 10.21037/jtd.2016.06.60

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BACKGROUND Recurrence of pectus excavatum (PE) is not an uncommon problem after open repair using the Ravitch technique. The optimal approach for redo surgery is still under debate, especially in adults with less chest wall pliability. Aim of this study was to investigate the usefulness and efficacy of the minimally invasive Nuss technique for repair of recurrent PE after conventional open repair. METHODS We performed a retrospective multicentre review of 20 adult patients from University Hospital Bern (n=6) and the US Mayo Clinic (n=14) who underwent minimally invasive repair of recurrent PE after unsuccessful prior Ravitch procedure. RESULTS Mean patient age at primary open correction was 21 years, with recurrence being evident after a mean duration of 10.5 years (range, 0.25-47 years). Mean age at redo surgery using the Nuss technique was 31 years, with a mean Haller index of 4.7 before and 2.5 after final correction. Main reason for redo surgery was recurrent or persistent deformity (100%), followed by chest pain (75%) and exercise intolerance (75%). No major intraoperative or postoperative complications occurred and successful correction was possible in all patients. CONCLUSIONS Although the procedure itself is more challenging, the minimally invasive Nuss technique can be safely and successfully used for repair of recurrent PE after failed open surgery. In our series final results were good to excellent in the majority of patients without major complications or recurrence.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Thoraxchirurgie
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery

UniBE Contributor:

Kocher, Gregor and Schmid, Ralph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2072-1439

Publisher:

Pioneer Bioscience Publishing

Language:

English

Submitter:

Thomas Michael Marti

Date Deposited:

24 Jan 2017 17:24

Last Modified:

24 Jan 2017 17:24

Publisher DOI:

10.21037/jtd.2016.06.60

PubMed ID:

27621850

Uncontrolled Keywords:

Pectus excavatum (PE); minimally invasive surgery; recurrence

BORIS DOI:

10.7892/boris.93742

URI:

https://boris.unibe.ch/id/eprint/93742

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