Thoracoscopic repair of pectus excavatum using different bar stabilizers versus open repair

Asian Cardiovasc Thorac Ann. 2014 Feb;22(2):187-92. doi: 10.1177/0218492313487180. Epub 2013 Oct 9.

Abstract

Objectives: To identify the preoperative characteristics and compare operative variables and postoperative outcomes in adult patients with pectus excavatum undergoing thoracoscopic repair using different bar stabilizers or open surgical repair.

Methods: 31 patients were randomly divided into 3 groups: group A was 9 patients who underwent a modified Ravitch repair, group B was 11 patients who underwent video-assisted thoracoscopic repair using metal stabilizers, and group C was 11 patients who underwent video-assisted thoracoscopic repair using absorbable stabilizers. Preoperative, intraoperative, and postoperative variables and mortality were compared among groups.

Results: In all groups, preoperative variables were well-matched for age, sex, and Haller index. Operative time was significantly longer in group A. The postoperative length of hospital stay was significantly shorter in group A. Postoperative complications occurred in 7 (22.6%) patients, mostly in groups B and C. All patients were satisfied with the cosmetic result.

Conclusions: Repair of pectus excavatum in adult patients can be performed effectively either through an open surgical technique or thoracoscopy, with no intraoperative complications and excellent immediate results, but video-assisted thoracoscopic repair using metallic or absorbable bar stabilizers gives a better cosmetic result; however, absorbable bar stabilizers are more vulnerable and break more easily than metal stabilizers.

Keywords: Nuss repair; Pectus excavatum; Ravitch repair; video-assisted thoracoscopy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Absorbable Implants*
  • Adolescent
  • Adult
  • Female
  • Funnel Chest / diagnosis
  • Funnel Chest / surgery*
  • Humans
  • Length of Stay
  • Male
  • Metals
  • Operative Time
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / instrumentation*
  • Patient Satisfaction
  • Prospective Studies
  • Prosthesis Design
  • Saudi Arabia
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / instrumentation*
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Metals