Long term results in children underwent nuss procedure preschool with pectus excavatum: Real-world study with propensity matching

Abstract

BackgroundIt is controversial when surgery should be performed for pectus excavatum (PE). The study retrospectively compared the long-term prognosis in PE children undergoing the Nuss procedure at the age of 4–6 versus those performing surgery at the age of 12–14. Methods178 patients were included in the retrospective real-world research. Clinical Characteristics were collected at baseline. The endpoint of the study was set as the last follow-up at the age of 18 in outpatient services. Satisfaction and complication rate were set as the primary outcome and were collected at the endpoint. Hospital stay post-surgery and analgesia dosage were regard as the secondary outcome. To reduce potential bias between two different age groups, propensity score matching (PSM) analysis was analysized. ResultsThe oral analgesic dosage of children in the 4–6 years old age group is significantly lower than that of the 12–14 years old group (0.70/kg, 0.30–1.50/kg versus 1.50/kg, 0.90–2.30/kg, P < 0.001), and children in the younger age group are discharged earlier. There was no difference in overall satisfaction (89.1 %, versus 88.20 %, P = 0.99) and recurrence rate (7.2 %, versus 6.8 %, P = 0.99) between the two groups of when they reach the age of 18. ConclusionsPerforming Nuss procedure at the age of 4–6 does not affect the overall long-term satisfaction of the child or increase the long-term recurrence rate. Surgical intervention in children with pectus excavatum preschool can provide a better postoperative experience in hospital compared with intervention in adolescent.