CORRECTION OF PECTUS EXCAVATUM WITH A SELF-RETAINING SEA-GULL WING PROSTHESIS - LONG-TERM FOLLOW-UP

Between June 1958 and December 1991, 315 patients (217 male and 98 fem ale, mean age = 17.8 +/- 5.5 years) affected by pectus excavatum (PE) were surgically treated, Most of the patients required operation for a esthetic reasons only (299 patients; 95 percent). The grade of PE (Chi n classification) was I in 72 patients, II in 152, and III in the rema ining 91. The surgical technique consisted of a double transversal ste rnotomy at the level of the lowest and highest part of the depression associated with a longitudinal sternotomy. A wedge resection of the ri bs was then performed and the sternum was fixed using a stainless stee l strut molded into a seagull wing prosthesis, The strut was removed 1 2 months postoperatively. There were no operative mortalities, Four pa tients had sternal wound infection that was successfully treated, The mean follow-up was 15.8 years per patient and was 60 percent complete. From the aesthetic point of view, the postoperative results were exce llent in 246 patients (78 percent), good in 57 (18 percent), and poor in 12 (4 percent), All subjective symptoms, when present, disappeared after surgery. The seagull wing prosthesis appears to be safe,easy to implant and to remove, and comfortable for the patient. This technique has shown good long-term results independently of type of deformity a nd patient age.