Twenty-One Years of Experience With Minimally Invasive Repair of Pectus Excavatum by the Nuss Procedure in 1215 Patients

Abstract

The minimally invasive repair of pectus excavatum has been performed safely and effectively in 1215 patients with a 95.8% good to excellent anatomic result in the primary repairs at our institution.

Chest Wall Deformities: An Overview on Classification and Surgical Options

“…Results in all series (Acastello, 2006;Kelly et al, 2007;Lopushinsky & Fecteau, 2008;Nuss, 2008) are usually good in more than 80-90% of cases, depending on the gravity, type of PE and age of correction. The largest experience of 1215 patients is reported by Nuss and colleagues (Kelly et al, 2010), who report a 95.8% surgeon's satisfaction rate, 93% patient's satisfaction rate and a 92% parent's satisfaction rate. It remains to be defined which technique between Nuss procedure and open resections can guarantee better results, however nowadays Nuss procedure is far more used because it is less invasive and does not leave anterior scars.…”

“…In case of Nuss bar infection, this can be managed successfully conservatively (Van Renterghem et al, 2005). Recurrence is reported in a range between 2% and 5% (Kelly et al, 2010;Lopushinsky & Fecteau, 2008). In our experience, in case of suboptimal result, one or more lipofilling treatments can improve significantly the final outcome but there are no published series yet.…”

“…It remains to be defined which technique between Nuss procedure and open resections can guarantee better results, however nowadays Nuss procedure is far more used because it is less invasive and does not leave anterior scars. The complications observed both in open and mini-invasive procedures are wound infections, hematomas, bar shifts, pneumothorax, transient Horner syndrome, bleeding from thoracic vessels, overcorrection or mild correction (Acastello, 2006;Haller et al, 1987;Kelly et al, 2010;Lopushinsky & Fecteau, 2008;Nuss, 2008;Park et al, 2004). Complications of an extensive open procedure, particularly at early age, are floating sternum (Prabhakaran et al, 2001) and acquired Jeune syndrome (Haller et al, 1996), while in Nuss procedure pericarditis and allergy to nickel (component of the metal bar) have been reported occasionally (Nuss, 2008).…”

Pectus excavactum-insights into its diagnosis and the current treatment options along with its clinical outcomes: two case reports

“…23 Despite the success rate of MIR technique in children which are richly reported in the various literature, extending this procedure to adolescents, adults, athletic persons, and asymmetric cases have remained a subject of discussion. 24 Recently, almost all modern techniques are based on the MRR technique, except the Nuss procedure with surgical indications for pectus repair been the cosmetic aspect of the deformity, physiological, psychological and or orthopedic postural defects, with the cosmetic aspects of utmost importance to female patients. 25 In addition to the cosmetic aspects of the repair, application of the MRR procedure produces better results as this technique uses inframammarian incisions thereby concealing the scars right below the breast tissue in both supine and upright positions.…”

Evaluation of the internal thoracic artery blood flow before and after Nuss operation: is it reversible?

“…Large incisions and scars limit this operation's satisfactory results. For more than 20 years, minimally invasive repair of pectus excavatum (MIRPE) has become a widely used technique in the clinical settings [6,7]. This technique, which is first described in 1987 by Dr. Donald Nuss, enables thoracic surgeons correcting these deformities with small bilateral incisions for using a retrosternal shaped bar inserted by a thoracoscope [8].…”