Summary
Background
In the standard Nuss procedure for pectus excavatum, the costal arch is often elevated
together with the sternum, resulting in unevenness of the lower part of the thorax.
This complication is commonly called rib flaring. This paper presents a technique
to avoid rib flaring and evaluates its effectiveness.
Materials and Methods
In our technique, a part of the seventh costal cartilage is removed, disconnecting
the costal arch from the sternum. The effectiveness of this technique was evaluated
in a retrospective clinical study of 63 pectus excavatum patients who were randomly
collected and were divided into two groups. One group―defined as the Standard Group—includes
27 patients (29.8 ± 6.5SD y/o) on whom standard Nuss procedure was conducted; the
other group―defined as the Separation Group−includes 36 patients (31.8 ± 6.1SD y/o)
on whom the cartilage removal was conducted in addition to the standard Nuss procedure.
The degree of postoperative costal-arch elevation was defined as ECA (Elevation of
Costal Arch) and was compared between the two groups.
Results
ECA was significantly greater for the Standard Group (10.2 ± 3.3SD mm) than for the
Separation Group (-1.1 ± 3.42SDmm).
Conclusion
Postoperative protrusion of the costal arch is prevented by the separation of the
seventh costal cartilage from the sternum. Our original technique is a useful option
for the treatment of pectus excavatum.
Keywords
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Article info
Publication history
Published online: October 11, 2022
Accepted:
October 4,
2022
Received:
March 1,
2019
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
