Long-term Surveillance Comparing Satisfaction between the Early Experience of Nuss Procedure vs. Ravitch Procedure

Abstract

BackgroundLong-term surveillance comparing satisfaction between the early experience of Nuss procedure vs. Ravitch procedure.Materials and MethodsA total of 100 patients that underwent surgical correction of a pectus excavatum between 2001 and 2004 and were followed for ≥2 years were included. Surveillance on the degree of satisfaction was performed using five-levels of the Likert scale and self-assessment scoring.ResultsNuss or Ravitch surgery was performed in 63 and 37 patients, respectively. The Nuss procedure required a shorter operation time and shorter hospital stay than the Ravitch procedure (p<0.001). The surveillance demonstrated that 17.6% of the Nuss group and 35.7% of the Ravitch group were not satisfied with the outcome of the surgery (p=0.072). The most common causes of dissatisfaction were redepression in the Nuss group (n=5) and incomplete correction in the Ravitch group (n=7). The multivariate analysis showed that reoperation and a high postoperative pectus index were significant risk factors for a low satisfaction score.ConclusionThe Nuss procedure had several advantages over the Ravitch procedure in the immediate postoperative period. However, the long-term satisfaction was determined by a complete correction without recurrence or need for re-intervention rather than by the operation type.

Comparison of Postoperative Period in Patients with Pectus Excavatum Treated with Nuss Technique and Ravitch Technique

“…Many studies have shown that the level of satisfaction with surgery is nearly the same regardless of the technique [16,21,27]. Patient satisfaction is decreased by recurrence of the deformity after Nuss surgery or incomplete correction in the Ravitch procedure, which was also the case in our study group [28]. A high postoperative Haller index was found in those patients who were not satisfied with the outcome of the surgery.…”

“…Czyn ni kiem, któ ry ob niża tę oce nę jest na wrót de for ma cji po ope ra cji Nus sa bądź nie peł na ko rek cja w tech ni ce Ra vit cha. Tak też by ło w ba da nej gru pie [28]. Wy so ki wskaź nik Hal le ra w ba da niu po ope ra cyj nym obec ny był u tych cho rych, któ rzy nie wy ra ża li za do wo le nia z wy ni ku ope ra cji.…”

Pectus Excavatum: A Review of Diagnosis and Current Treatment Options

“…40,41 This intervention at too young of an age (6 years or isfaction rates have been reported to be high. 14,43,44 Some surgeons still advocate the Ravitch procedure for older adults and asymmetric anomalies. 3,40 However, in children and adolescents, the Ravitch procedure has generally been replaced with minimally invasive procedures such as the Nuss procedure.…”

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.…”