1136 Modified Nuss Bar Procedure for Pectus Excavatum – Our Experience in Patients Aged 20 and Over

Background

Pectus excavatum (PE) is a common congenital anterior chest wall deformity characterized by a sunken appearance. The incidence rate is approximately 0.1% with a male to female ratio of 4:1. It is associated with connective tissue disorders, neuromuscular diseases, and linked with some genetic conditions.

In 1987, the Nuss procedure was invented by Dr Nuss and his colleagues as a minimally invasive procedure to correct PE. This is a two-staged procedure and involved lesser hospital stays, smaller incisions, and early mobilisation. Applying this procedure to video-assisted thoracoscopic surgery (VATS), we present our experience on insertion as well as removal of the Nuss bar in patients aged 20 and over with PE.

Method

This is a single centre, retrospective study carried out in a tertiary cardiothoracic centre. A total of 104 patients, aged 20-57 years, who underwent Nuss bar insertions and removals between 2016 and 2021 (5 years) were included in our study. All the procedures were performed by a single consultant cardiothoracic surgeon using biotech stainless steel bars.

Results

A total of 24 bar insertions, 79 bar removals and 1 bar revision were performed between 2016-2021. The data included 95 male and 9 female patients. The average hospital stay was 2.5 days.

Postoperative complications for the procedure included pleural effusions (3%), pericardial effusion (0.9%), post-operative bleeding requiring re-operation (0.9%), bar dislodgement (0.9%) and wound infection (4%).

Conclusions

We can conclude that VATS-Nuss procedure is a safe procedure for adult patients resulting in shorter hospital stays and reduced post-operative complications.