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Advances in Pediatrics

Minimally Invasive Surgical Correction of Chest Wall Deformities in Children (Nuss Procedure)

      Patients routinely report a marked increase in their exercise tolerance and their ability to participate in competitive sports after minimally invasive pectus repair. Recent studies have confirmed that there is a significant improvement in the pulmonary function tests [
      • Kelly Jr., R.E.
      • Shamberger R.C.
      • Mellins R.B.
      • et al.
      Prospective multicenter study of surgical correction of pectus excavatum.
      ,
      • Lawson M.L.
      • Mellins R.B.
      • Tabangin M.
      • et al.
      Impact of pectus excavatum on pulmonary function before and after repair with the Nuss procedure.
      ] and cardiac output [
      • Sigalet D.L.
      • Montgomery M.
      • Harder J.
      Cardiopulmonary effects of closed repair of pectus excavatum.
      ,
      • Coln E.
      • Carrasco
      • Coln D.
      Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum.
      ,
      • Malek M.
      • Berger D.E.
      • Housh T.J.
      • et al.
      Cardiovascular function following surgical repair of pectus excavatum: a metaanalysis.
      ,
      • Keiko K.
      • Ueno T.
      • Kobayashi T.
      • et al.
      Tc-99m MAA SPECT in pectus excavatum assessment of perfusion volume changes after correction by the Nuss procedure.
      ] following the minimally invasive repair of pectus excavatum, a procedure that requires no rib or sternal resection. Patient satisfaction and quality of life surveys [
      • Lawson M.
      • Cash T.
      • Akers R.
      A pilot study of the impact of surgical repair on disease-specific quality of life among patients with pectus excavatum.
      ,
      • Roberts J.
      • Hayashi A.
      • Anderson J.O.
      • et al.
      Quality of life of patients who have undergone the Nuss procedure for pectus excavatum: preliminary findings.
      ] have shown that over 90% of the patients are happy with the outcome of their minimally invasive pectus excavatum repair and have improved body image and self-confidence (Fig. 1, Fig. 2).
      Figure thumbnail gr1
      Fig. 1(A) Patient showing severe pectus excavatum. (B) Same patient after minimally invasive pectus repair.
      Figure thumbnail gr2
      Fig. 2(A) A 16-year-old with asymmetric pectus excavatum. (B) Same patient 6 months after minimally invasive correction. (C) Same patient 6 months postrepair.
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