Minimally invasive repair of pectus excavatum: report of a beginning experience

Abstract

<bold>Introduction:</bold> Pectus excavatum (PE) is the most frequent chest wall deformity. Even in the absence of a significant cardiorespiratory compromise, the psychological impact of PE may be important, especially in adolescent population. Therefore, minimally invasive repair of PE (MIRPE) may be encouraged in this age group. We reported herein, our beginning experience with MIRPE and tried to determine the best timing for surgery. <bold>Methods:</bold> Since December 2019, we switched our surgical technique for PE repair and adopted MIRPE. Records of patients who were managed by MIRPE between December 2019 and December 2023, were analyzed. <bold>Results:</bold> There were 7 patients, with an age ranging between 14 and 28 years. PE was associated with scoliosis in 2 cases. All patients complained of dyspnea and discomfort in everyday activities. At CT-scan, maximum Haller index found was 6.5 and maximum sternal torsion angle was 38°. Preoperative ultrasonography did not show any associated valvular or aortic disease. Pulmonary function tests found a restrictive syndrome in 2 cases. All the procedures were uneventful. The postoperative stay ranged between 3 and 11 days. One patient presented a pneumothorax postoperatively. Another patient presented postoperative tachycardia due to clearance of right cardiac cavities compression. All the patients were satisfied with the results of the surgical repair. <bold>Conclusion:</bold> Repair of PE at a later age may be problematic due to less chest wall elasticity. Therefore, patients with PE should be operated at discovery, and MIRPE may be the procedure of choice. Preoperative assessment of associated possible spine or cardiac anomalies is mandatory in order to correct them on time.