Extending the use of Nuss procedure in patients older than 30 years

Abstract

Objective: The Nuss procedure was originally thought to be the method to correct pectus excavatum in children and teenagers. It is now a well-established technique, and is also used in older patients. The aim of this study was to investigate the results in patients ≥ 30 years of age.

Methods: Since 2001, we have routinely used the Nuss procedure for correction of pectus excavatum in more than 700 patients. The indication for surgery has been disabling cosmetic appearance. All operations have been performed by the same surgeon. Patient records were retrospectively analyzed.

Results: The study included fifty-two patients, who were ≥ 30 years or older (range 30-53 years), with median age 37 years; and 85% were males. There was no operative mortality. Nearly three-quarters (70%) needed two bars or more to obtain a satisfactory perioperative result. The median operating time was 60 min (range 18-104 min). The median postoperative stay was 4 days (range 3-29 days). Postoperative complications were few; one patient developed deep infection after re-operation caused by lateral dislocation of the bars.

Conclusion: The Nuss procedure can be used in older patients with excellent results. The operation time in their case is longer than in young patients because more patients need two bars; but the postoperative stay is equivalent to that in young patients.