Corrección mínimamente invasiva (Operación de Nuss) del pectus excavatum en pacientes adultos / Minimally invasive correction of pectus excavatum among adults. Report of eighteen cases

ABSTRACT

Background: A minimally invasive technique or Nuss procedure was devised for children with pectus excavatum (funnel chest), but it is also used in adult patients. Aim: To report the experience with the Nuss procedure in adults' patients with pectus excavatum. Material and methods: Prospective study of patients operated between January 2007 and January 2009. Clinical features, symptoms, operative time, postoperative complications, hospital stay and quality of life, using the Nuss questionnaire adapted for adults, was recorded. Results: Eighteen patients aged 18±2 years (14 males) were operated. Seven patients had scoliosis, two had depression, two had asthma and one had a Marfan syndrome. AU patients were concerned about aesthetic issues, nine had dyspnea, three had compression of cardiac cavities and three had pulmonary function disturbances. Haller index was 3.8. Mean operative time was 92 minutes. Postoperative complications were a pneumothorax without chest tube management in two patients, a peridural hematoma in one patient and a bar stabilizer infection that required a reoperation in one patient. No patient died and the mean hospital stay was six days. The Nuss questionnaire scores in the pre and postoperative periods were 33 and 48, respectively (p <0.05). Conclusions: Nuss operation is feasible and safe in adults with pectus excavatum.