Experience of the Wang procedure in treating pectus excavatum in two hundred fifty-six paediatric patients

Int Orthop. 2022 Oct;46(10):2307-2313. doi: 10.1007/s00264-022-05483-1. Epub 2022 Jul 4.

Abstract

Introduction: To analyze and summarize the orthopaedic effect and application experience of the Wang procedure in the treatment of pectus excavatum in paediatric patients.

Methods: The clinical data of 256 children ranging from 0.83~14 years (4.89±2.83 years) who underwent the Wang procedure for pectus excavatum from January 2017 to September 2020 in our hospital were analyzed retrospectively. A 1~2-cm incision was made in front of the xiphoid, and a tunnel was constructed on the deep surface of the thoracic cage. Steel wires were inserted through the bilateral costal arch and the lower sternum, and a steel bar was placed in the tunnel. The wires were pulled taut and fixed to the bar, and the incision was sutured.

Results: All the procedures were performed using one steel bar. The range of the procedure duration, the intra-operative bleeding volume, and the hospitalization stays of the patients were 18 to 45 (24.02±4.89) minutes, one to ten (2.16±1.68) mL, and three to nine days (5.71±1.35 days) respectively. Post-operative pneumothorax occurred in three cases without other complications. All the cases received follow-up for one to 45 months after discharge, during which six cases experienced poor wound healing, removed steel plate in 82 cases, and three cases of pectus excavatum recurrence.

Conclusions: The Wang procedure is a good option for treating pectus excavatum, secondary pectus excavatum, or recurrent pectus excavatum in paediatric patients.

Keywords: Minimally invasive surgery; Pectus excavatum; Wang operation.

MeSH terms

  • Child
  • Funnel Chest* / surgery
  • Humans
  • Minimally Invasive Surgical Procedures
  • Retrospective Studies
  • Rib Cage
  • Steel
  • Sternum
  • Surgical Wound*
  • Treatment Outcome

Substances

  • Steel