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.

Cervical anastomosis resulted in a better outcome for esophagogastrostomy by lowering the risk of reflux esophagitis; this outcome might improve the patient's quality of life.

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resection was recommended to prevent local tumor recurrence, even if this operation impaired the patient's quality of life (bypass, valve replacement, and ventricular septal defect patch closure). 2 Cases of cardiac transplantation to treat these fibromas have also been reported. 4 However, subtotal resection seems to be the best therapeutic option when the size or location of the tumor makes total resection impossible. The risk of tumor regrowth seems to be relatively low. Several colleagues have described the absence of tumor progression at long-term follow-up, even if the number of cases reported is low. Finally, transplantation does not seem to be an acceptable option, even with voluminous fibromas; subtotal resection should be the treatment of choice. 5 Even if it is widely accepted that fibromas should be totally resected because of their recurrence risk, subtotal surgical intervention might be an acceptable option when the volume or location of the tumor makes total resection a high-risk procedure.

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