Abstract
Purpose: The Nuss procedure, a minimally invasive method for pectus excavatum repair, has been used worldwide. We evaluated the morphometric changes of the thorax before and after the Nuss procedure to clarify the correction effect.
Methods: Thirty-two patients who underwent Nuss procedure were included in the study. The mean age at surgery was 11.3 years, and the male to female ratio was 28 : 4. We traced the shape of the anterior chest wall in the lower end of the sternum by Orthoglass® before and after surgery, and measured the height from the dorsal line. We set 5 points for the measurement, depressed point (D), right and left top (RT·LT), and right and left midpoint between the top and the end of thorax (RM·LM). The transformation rates (postoperative/preoperative value) were calculated. In addition, the ratio of the depressed point (D) and the average of the top points ((RT + LT)/2) was calculated. The preoperative and postoperative values were named as the depression rate and elevation rate, respectively.
Results: The mean transformation rates in each point were as follows. D; 1.308 ± 0.109, RT; 1.025 ± 0.045, LT; 1.018 ± 0.055, RM; 0.936 ± 0.043, and LM; 0.937 ± 0.037. The mean depression rate was 0.861 ± 0.065, and elevation rate was 1.097 ± 0.045.
Conclusions: Elevation at the depressed point showed 10% higher than both the tops. Both the tops were only 2% higher and the both midpoints were 6% lower. Postoperative morphometric changes after the Nuss procedure were observed not only in the sternal elevation but also the whole chest remodeling according to the shape of the bar.
