We analyzed the data of 1170 consecutive patients with pectus excavatum who underwent minimally invasive repair between August 1999 and September 2008. All pectus repairs were performed by the primary author (H.J.P.) with our modified technique.
The mean age was 10.3 years (range, 16 months to 51 years). There were 331 adult patients (>15 years) (28.3 % ). A total of 576 patients (49.2 % ) had bar removal after a mean of 2.5 years (range, 10 days to 7 years). The asymmetry index change (1.10–1.02, P < .001) demonstrated post-repair symmetry. Complication rates decreased through the 3 time periods (1999–2002 [n = 335]; 2003–2005 [n = 441]; 2006–2008 [n = 394]) as follows: pneumothorax rate (7.5 % vs 4.3 % vs 0.8 % ; P < .001) and bar displacement rate (3.8 % vs 2.3 % vs 0.5 % ; P = .002). Reoperation rate also decreased (4.8 % vs 2.5 % vs 0.8 % ; P = .002). Satisfaction outcomes were excellent in 92.7 % , good in 5.9 % , and fair in 1.4 % of patients. After bar removal, 3 patients (0.6 % ) had minor recurrences.
Minimally invasive repair of pectus excavatum based on a novel morphology-tailored, patient-specific approach is effective for quality repair of the full spectrum of pectus excavatum, including asymmetry and adult patients. Continuous technical refinements have significantly decreased the complication rates and postoperative morbidity.