Nuss procedure for pectus excavatum in adults: long-term results in a prospective observational study.

Hoksch, Beatrix; Kocher, Gregor; Vollmar, Philippe Bernard; Praz, Fabien; Schmid, Ralph (2016). Nuss procedure for pectus excavatum in adults: long-term results in a prospective observational study. European journal of cardio-thoracic surgery, 50(5), pp. 934-939. Oxford University Press 10.1093/ejcts/ezw130

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OBJECTIVES Since the end of the 1990s, the management of pectus excavatum has undergone major changes. The Nuss procedure (pectus bar) has been the method of choice for patients with pectus excavatum at Bern University Hospital for over a decade. The current study will describe our experiences, with a particular focus on long-term results in adults. METHODS The prospective observational study began in autumn 2002. The Haller index was used to quantify pectus excavatum severity. Pulmonary function tests and cardiac examinations were performed preoperatively, and a standardized management for surgical techniques and for the pre- and postoperative treatments including long-term follow-up at 3, 12 and 36 months after surgery was developed. Quality of life and satisfaction with the cosmetic result after the Nuss procedure were evaluated. RESULTS Better or much better quality of life after the Nuss procedure was observed: n = 108 (88.4%) at 3 months, n = 97 (89.0%) at 12 months and n = 87 (92.5%) at 36 months. Pain intensity decreased in the follow-up [pain score visual analogue scale (VAS) at 3 months: median 1 (0-7), 12 months: median 1 (0-4), 36 months: median 0.8 (0-5)]. After long-term observation, over 90% of patients described their quality of life after the operation as being better or much better. Satisfaction with the cosmetic results of the operation was also very high, with >90% of patients being satisfied. Only a very small group of patients suffered from pain in the long-term follow-up. Complications were rare (14.7%) and could be treated in most cases without reoperation. CONCLUSION Our results demonstrate that the Nuss procedure is safe and can be performed with excellent results in adults, both in the short term and in the long term. The improved quality of life and patients' satisfaction with cosmetic results remained high in the long-term follow-up, 10 years after the surgical procedure.

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
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Hoksch, Beatrix; Kocher, Gregor; Vollmar, Philippe Bernard; Praz, Fabien and Schmid, Ralph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1010-7940

Publisher:

Oxford University Press

Language:

English

Submitter:

Thomas Michael Marti

Date Deposited:

25 Jan 2017 10:37

Last Modified:

25 Jan 2017 10:37

Publisher DOI:

10.1093/ejcts/ezw130

PubMed ID:

27126132

Uncontrolled Keywords:

MIRPE; Nuss procedure; Pectus Bar; Pectus excavatum

BORIS DOI:

10.7892/boris.93800

URI:

https://boris.unibe.ch/id/eprint/93800

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