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Pectus excavatum repair
Alternative namesFunnel chest repair; Chest deformity repair
DefinitionSurgery to correct pectus excavatum , a deformity of the front of the chest wall with depressed breastbone (sternum) and ribs.
There are various surgical approaches for treating this condition. In the most commonly used approach, while the child is deep asleep and pain-free (using general anesthesia), an incision is made over the sternum. The deformed cartilages are removed and the rib lining is left in place to allow the cartilages to regrow.
An incision is made in the sternum and it is repositioned. A rib or metal strut may be used to stabilize the sternum in normal position until healing occurs in 3 to 6 months. A temporary chest tube may be placed to reexpand the lung if the lining of the lung is entered.
Metal struts are removed 6 months later through a small skin incision under the arm. This procedure is usually done on an outpatient basis. Most repairs are done between 18 months and 5 years of age, although there has been debate about the best age for the procedure.
A newer, less invasive approach involves the placement of a curved steel bar beneath the sternum to elevate the deformed sternum and cartilages without removal of any bone or cartilage. The bar is later removed, after two to four years. There are advantages and disadvantages compared to the more invasive approaches, and long-term results with this approach are not yet available.
IndicationsPectus excavatum repair may be recommended for:
RisksThe risks for any anesthesia are:
Expectations after surgeryCosmetic results are generally good. The success of the procedure to improve breathing or exercise capacity is variable. Many affected children have other connective tissue disorders, and thus need related surgery.
ConvalescenceHospitalization for 1 week is common. Vigorous activity may need to be restricted for 3 months.
Update Date: 11/6/2003Grace Jeon, M.D.,M.P.H., General Surgeon, Pasadena, CA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT