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Minimally-Invasive Repair of Pectus Excavatum Marmara Experience

Mustafa Yüksel, Nezih Onur Ermerak, Çağatay Çetinkaya, Bihter Sayan, Tunç Laçin

Marmara University, Faculty of Medicine, Department of Thoracic Surgery, Istanbul

 

Objectives: Minimally Invasive Repair of Pectus Excavatum (MIRPE) gained popularity among surgeons during last decade. MIRPE became the treatment of choice for these patients because of successful results and high patient satisfaction. In this abstract we present our experience of 618 patients who had been operated by MIRPE.

Methods: We operated 618 pectus excavatum patients by MIRPE between August 2005 – March 2016. We recorded data on database in terms of demographics, type of the deformity, number of bars implanted, duration of the surgery, complications. Those data have been evaluated retrospectively.

Results: Among 618 patients; 540 (87 %) were male and 78 were female (13 %). Median age was 16 (6-46). 442 (71 %) of them had symmetric deformity and 176 (% 29) had asymmetric deformity. We repaired the deformity with 1 bar in 411 (66 %) patients, with 2 bars in 204 (33 %) patients and with 3 bars in 3 (1 %) cases. Median duration for the operation was 50 minutes and median length of hospital stay was 5 days (2-10 days). Pneumothorax (30 patients) and pleural effusion (7 patients) were the most frequent early complications. 11 of those patients needed chest tube drainage. Wound infection (39 patients), insufficient correction (16 patients) and nickel allergy (9 patients) were the leading late complications. Up to date, bars of 300 (48,5 %) patients had been removed as planned. We experienced recurrence only in 3 patients after bar removal. Quality of life questionnaire revealed 95 % patient satisfaction.

Conclusion: MIRPE is the treatment of choice in pectus excavatum patients because of being minimally invasive low mortality and short length of hospital stay. It can be performed with low morbidity and high patient satisfaction in experienced hands.

Keywords: pectus excavatum, MIRPE, experience, Nuss