Surgical correction of pectus excavatum: the Munster experience

Objectives: Pectus excavatum is the most common congenital hereditary chest -wall deformity. This study analyses a single-center experience of pectus e xcavatum-thoracic wall reconstruction using a uniform technique of internal stabilization employing stainless steel struts. Methods: From June 1984 to December 1997, we performed correction operations on 777 patients with pec tus excavatum. The condition occurred more frequently in boys (621 patients ) than girls (156 patients). Surgical repair was performed using a standard method of double bilateral chondrotomy parasternally and at points of tran sition to normal ribs. This was followed by detorsion of the sternum, retro sternal mobilization and correction of the inverted ribs. The anteriorly di splaced sternum was stabilized by one trans-sternal and two bilateral paras ternal metal struts. Results: The corrections were completed with successfu l repair in 765 patients (98.5%) with a low complication rate of 6.7%. The follow-up period ranged from 4 weeks to 12 years, mean 6.4 years, major rec urrences were observed in 12 patients (1.5%) and mild recurrence were obser ved in 35 patients (4.5%). Conclusion: Significant reduction in postoperati ve cardiorespiratory disorders, low lethality, improvement of subjective co mplaints, satisfactory long-term results and improvement in psychological p roblems indicate the need to offer this method of surgical correction to lo w-risk children.