Endoscopic correction of pectus excavatum.

Abstract

Pectus excavatum has been most commonly corrected by either the sternal elevation or turnover methods. Both of these procedures require a long skin incision in the anterior chest wall. Endoscopic techniques have been introduced into the treatment of pectus excavatum since 1994 to minimize the skin incision to approximately 1 inch. Thirty patients with pectus excavatum (25 men and 5 women) underwent surgery employing the centimeter incision method assisted by the endoscope. The mean age at the time of surgery was 11.9 years (range, 4-45 years). The patients were classified as having one of three types of pectus excavatum: Type I (symmetrical and localized) was seen in 18 patients (60%), type II (symmetrical and diffuse) was seen in 5 patients (17%), and type III (localized or diffuse but asymmetrical) was seen in 7 patients (23%). Although the results of the thoracic cage correction achieved using our procedure were excellent overall, the results were best for type I, with clear improvement achieved in the funnel index-0.48 to 0.63. All of the patients recovered well without any severe complications, and both the patients and their families found the results obtained using this method to be quite satisfactory, especially because of the minimal postoperative scar.