Long-term observation in 68 patients operated on for pectus excavatum: Surgical repair of funnel chest

Background. Recurrence after correction of pectus excavatum may sometimes o ccur, but its origin is not clear. The type of deformity, surgical techniqu e, and patient lifestyle after operation can all affect the final shape of the thorax. The purpose of the present study was to compare the short-, med ium-, and long-term cosmetic results of funnel chest repair. Methods. Sixty-eight patients (mean age, 12.1 +/- 5.4 years; 48 male) were operated on for pectus excavatum using the same surgical technique: subperi chondrial resection of the abnormal costal cartilages and stabilization of the elevated anterior chest wall with Kirschner's wires. The patients were followed up every year (1 to 10 years) after operation, and the anterior ch est wall contour was checked by physical examination and x-ray film. Results. Excellent to good cosmetic results 1 year after operation were ach ieved in 66 patients (97.1%). During the later follow-up period, a mild or moderate degree of recurrent sternal depression was noted in 6 patients (8. 8%), teenagers only, 3 to 9 years after primary repair. Conclusions. Our technique for correction of pectus excavatum yields good s hort-term cosmetic results. Late recurrence of the deformity occurs during pubertal growth and does not appear to depend on surgical technique or leng th of follow-up. (Ann Thorac Surg 1999;67:821-4) (C) 1999 by The Society of Thoracic Surgeons.