TL;DR: This minimally invasive technique, which requires neither cartilage incision nor resection for correction of pectus excavatum, is effective and has had excellent long-term results.
TL;DR: A pectus index can be derived from dividing the transverse diameter of the chest by the anterior-posterior diameter on a simple CT scan and may be a useful adjunct in objective evaluation of children and teenagers for surgery of pectu excavatum.
TL;DR: The technical improvements and changes in management that have occurred over 21 years, which have made the minimally invasive repair of pectus excavatum safer and more successful are reviewed.
Abstract: Objective:Toreviewthetechnicalimprovementsandchangesinmanagement that have occurred over 21 years, which have made the minimally invasive repair of pectus excavatum safer and more successful. Summary Background Data: In 1997, we reported our 10-year experience with a new minimally invasive technique for surgical correction of pectus excavatum in 42 children. Since then, we have treated an additional 1173 patients, and in this report, we summarize the technical modifications which have made the repair safer and more successful. Methods: From January 1987 to December 2008, we evaluated 2378 pectus excavatum patients. We established criteria for surgical intervention, and patients with a clinically and objectively severe deformity were offered surgical correction. The objective criteria used for surgical correction included computed tomography (CT) scans of the chest, resting pulmonary function studies (spirometry and/or plethysmography), and a cardiology evaluation which included echocardiogram and electrocardiogram. Surgery was indicated if the patients were symptomatic, had a severe pectus excavatum on a clinical basis
TL;DR: The minimally invasive technique has evolved into an effective method of pectus excavatum repair and reduced complications, and long-term results continue to be excellent.