Carinatum Research Articles

Quality Improvement Initiative: Foley Catheters in Patients Undergoing Pectus Deformity Repair

Background and Hypothesis: Pectus excavatum and carinatum are sternal deformities that often require surgeries with significant postoperative pain that can limit a patient’s ability to void. An indwelling urinary catheter is placed for the operation, but is often removed on the first postoperative day due to concerns of infection, which begs the necessity of these catheters in the first place. In this study, we hypothesized that there would be no increased risk of urinary retention or urinary tract infection irrespective of whether urinary catheters were utilized.
 Experimental Design: A pre/post quality improvement study was undertaken of patients undergoing pectus excavatum/carinatum repair between June 1, 2015 and May 31, 2022. The pre intervention group spanned from June 1, 2015 to May 31, 2021, where Foley catheters were placed intraoperatively and removed the first postoperative day. Pediatric surgery and anesthesia groups changed practice effective June 1, 2021 and decided to no longer utilize urinary catheters in pectus repairs. Pre-intervention patients were acquired through the surgery billing database. Post-intervention patients were acquired prospectively. Rates of urinary retention (any event requiring mechanical intervention for voiding) and urinary tract infections (UTI, >100,000 CFU bacteria/mL urine) were compiled into REDCap. Data are expressed as percent of the total cohort.
 Results: Of 179 patients undergoing pectus repair (162 Excavatum, 17 Carinatum), 12 patients (6.7%) in the pre-intervention group experienced urinary retention. Of these, 9 received in/out catheterization, 1 had a Foley catheter replaced, and 2 underwent in/out catheterization and had a Foley replaced. There were no urinary tract infections recorded among the pre-intervention group.
 Conclusion and Potential Impacts: Urinary retention and UTI are rare in patients who have an indwelling urinary catheter. Data acquired over the next year from the post-intervention group will help determine the true necessity for these catheters in the perioperative pectus population.

Changes in self-image after pectus carinatum brace treatment

Background/PurposePectus carinatum (PC) is a chest wall deformity resulting in anterior protrusion of the chest. PC does not typically result in significant physical or cardiopulmonary symptoms, but patients with this condition can experience a disturbed body image, lower self-esteem and reduced quality of life. The purpose of this study was to investigate the relationship between self-image and non-surgical correction of PC using a brace. MethodsThis study was a descriptive, pre-post survey design. The sample included children ages 11 to <18 years undergoing PC treatment with the dynamic compressor system. Subjects completed the modified Pectus Excavatum Evaluation Questionnaire (mPEEQ) at the onset of bracing and again once PC correction was completed. ResultsNinety-seven subjects were enrolled at the time of bracing, and 41 achieved correction and took the second survey. The mean age was 14 years and 80% were male. There was a statistically significant (p<0.001) improvement in body self-image between the first and second surveys. ConclusionsNon-surgical correction of PC with the dynamic compressor system resulted in an improvement in the self-image of children. Prognosis studyLevel of Evidence II

Children's and Parents' Anxiety Levels pre and post Thoracoplasty. Play Specialist-based Intervention beneficial Outcomes

Paediatric surgery elicits anxiety in children and their parents. The present study tests the impact of Play Specialist-based intervention (PS) on children's and parents' anxiety pre and post thoracoplasty. The study was held at Gaslini pediatric hospital (Genoa, Italy) and involved families with a child undergoing thoracoplasty to correct children's pectus carinatum (PC) or excavatum (PE). Children provided with PS-based intervention (n=40) were compared with control children (n=32). The mothers of PS children (n=40) were compared with the control mothers (n=32), and the fathers of PS children (n=40) were compared with the control fathers (n=32). Visual Analog Scale (VAS) was administered to assess pre and post thoracoplasty anxiety. T-tests and Analyses of Covariance (ANCOVA), Bayes factors for t-tests and ANCOVA were computed. A significant interaction effect between time and group (i.e., PS and controls) emerged for children, mothers, and fathers. Bonferroni post-hoc analyses revealed that PS children's and PS mothers' postoperative anxiety was lower than controls' postoperative anxiety. PS fathers' experienced greater preoperative anxiety than controls and no significant differences with control fathers emerged in postoperative anxiety. PS-based intervention emerged to reduce children's and parents' anxiety over time, and to diminish children's and mothers' postoperative anxiety in comparison with the controls.

Remote treatment of pectus carinatum (Telepectus) during the COVID-19 pandemic

Background/PurposeTo report telemedicine's feasibility and satisfaction rates for treating patients with pectus carinatum using a dynamic compressor system. We analyzed treatment adherence in comparison with the previous, non-pandemic year. Materials and methodsRetrospective analysis including patients with pectus carinatum under treatment with a dynamic compressor system using telemedicine at the chest wall centers from two hospitals, private and public, between April and July 2020. A free video conference platform for teleconsultations was employed. We evaluated the incidence of pectus cases with telemedicine, the number of dynamic compressor system prescriptions, the number of patients in the correction phase, and the number who ended treatment. To assess adherence, we compared our cohort with an in-person cohort during the same time frame of the previous, non-pandemic year. In addition, we performed a patient satisfaction survey comprising questions related to socioeconomic status, the likeability of telemedicine, simplicity of modification of the system, and desire to continue with telepectus after the pandemic. ResultsOne hundred and thirty-six telepectus consultations were performed in 76 patients. During this time frame, 15 patients started using the dynamic compressor system. Compared to the previous, non-pandemic year, the number of consultations per patient was similar (2019: 1.92 ± 1 .0 vs. 2020: 1.79 ± 0.8, p = 0.32), and there was a significant reduction in the number of dropouts with the use of telemedicine (9% vs. 1%, p = 0.025). Fifty-nine patients answered the satisfaction survey. All of them solved their doubts through telemedicine. Overall, 95% found telemedicine comfortable. Of note, those with a lower income evidenced the highest intention in continuing with telemedicine. ConclusionsWe demonstrated the feasibility of remote care of patients with pectus carinatum using a dynamic compressor system with a similar frequency of consultations compared to in-person medical care. Telepectus patients revealed a high rate of satisfaction irrespective of their socioeconomic status. Level of evidenceIV. Type of studyRetrospective study.

A new minimally invasive technique for correction of pectus carinatum

BackgroundThe Abramson technique for the correction of pectus carinatum (PC) is commonly performed worldwide. However, the postoperative complications of this technique related to bar fixation, including wire breakage and bar displacement, are relatively high. In this study, a new minimally invasive technique for correction of PC is described, in which the pectus bar is secured by bilateral selected ribs, and for which no special fixation to the rib is needed.MethodsThe procedure was performed by placing the pectus bar subcutaneously over the sternum with both ends of the bar passing through the intercostal space of the selected rib at the anterior axillary line. The protruding sternum was depressed by the bar positioned in this 2 intra- and 2 extra-thorax manners. Between October 2011 and September 2019, 42 patients with PC underwent this procedure.ResultsSatisfactory cosmetic results were obtained in all the patients. The mean operation time was 87.14 min, and the mean postoperative stay was 4.05 days. Wound infection occurred in 3 patients, 2 were cured by antibiotics, and 1 received bar removal 4 months after the initial operation due to the exposure of the implant resulting from uncontrolled infection. Mild pneumothorax was found in 3 patients and cured by conservative treatment. One patient suffered from hydropneumothorax, which was treated with chest drainage. The bars were removed at a mean duration of 24.4 months since primary repair in 20 patients without recurrence.ConclusionsThis new technique for minimally invasive correction of PC deformity is a safe and feasible procedure yielding good results and minimal complications.

Analysis of Psychological Assessments Affecting Patients Undergoing Treatment for Chest Wall Deformities.

This study aimed to review the literature with regard to the psychological aspects in patients with pectus excavatum (PE) and pectus carinatum (PC). The literature was reviewed by analyzing articles on PubMed using the search terms "psychology" and "pectus." The literature search revealed 22 articles that offered a total of 2214 patients for analysis. Regarding chest wall deformities (CWD), there were 15 articles referring to PE, 4 articles on PC, and 3 pertaining to both PE and PC. Authors used various types of questionnaires and 14 studies which also included a parent questionnaire. There are 14 reports which analyzed both the preoperative and postoperative psychological status and 4 reports in which a control group was used. Treatment of CWD was shown to have consistently positive results. There is no consensus regarding the correlation between severity of CWD and psychological issues. Only 2 studies found no statistically significant results after treatment. The literature reveals a great concern for psychosocial issues in CWD patients. Most articles describe improvement in overall quality of life (QOL) after surgery. An increase in social and physical function, body image, and self-esteem was observed in CWD patients, which is supported by parent responses.

RAB33B and PCNT variants in two Pakistani families with skeletal dysplasia and short stature

BackgroundSkeletal dysplasia is a heterogeneous group of disorders resulting from different genetic variants in humans. The current study was designed to identify the genetic causes of skeletal dysplasia and short stature in two consanguineous families from Pakistan, both comprised of multiple affected individuals. Patients in one family had proportionate short stature with reduced head circumference while affected individuals in the other family had disproportionate short stature.MethodsClinical data were obtained and radiological examinations of the index patients were completed. Whole genome sequencing for probands from both families were performed followed by Sanger sequencing to confirm segregation of identified variants in the respective families. In-silico pathogenicity score prediction for identified variant and amino acid conservation analysis was completed.ResultsWhole Genome Sequencing identified a known biallelic variant c.6176_6189delGTCAGCTGCCGAAG; p.(Gln2060ArgfsTer48) in PCNT gene and a novel biallelic variant c.174delC; p.(Asp60ThrfsTer7) in RAB33B gene respectively in affected members of the two families. Clinical imaging revealed platyspondyly and varus deformity in the legs of the affected members in the first family. Radiographs indicated severe platyspondyly, genu valgus deformity of legs and pectus carinatum for the patients in the second family.ConclusionIn this study we report the phenotypes and genetic variants in two unrelated families with two distinct forms of skeletal dysplasia. This study strengthens the previous findings that patients harboring PCNT variants are phenotypically homogeneous and also extends the genotypic spectrum of RAB33B variants.

Cardiopulmonary function in adolescent patients with pectus excavatum or carinatum

BackgroundPectus excavatum (PE) and pectus carinatum (PC) have generally been considered an aesthetic issue, although there is growing evidence of associated cardiopulmonary function (CPF) impairment, especially in PE patients. The...

Preventing bar-related complications for chest wall deformities

Aim: Nuss procedure for pectus excavatum and Abramson procedure for pectus carinatum are used as minimally invasive methods for surgical treatment of chest wall defomities. The aim of this study is to investigate the causes of bar-related complications, and to present technical details of their management. Materials and Methods: Patients who underwent minimally invasive correction surgery with the diagnosis of pectus excavatum and pectus carinatum between 2011-2020 in our clinic were included in this study. The surgical treatments, bar related complications, and follow-up records of patients were recorded and analyzed retrospectively. Results: 141 patients with a mean age of 16.08 ± 4.38 were included in the study. Postoperative bar-related complications were encountered in 28 (19.8%) of all patients. There were no life-threatening early or late complications. The most common complication was skin reaction in 7 (4.9%) cases. Conclusion: Bar-related complications are problems that can cause morbidity and disrupt patient comfort, thus management of complications should be focused on.

Pectus excavatum in osteogenesis imperfecta type I treated with Nuss procedure after pamidronate therapy

Osteogenesis imperfecta is a genetic disorder caused by mutations in genes affecting type I collagen that is mostly found in bone, skin and tendons. In addition to bone fragility and increased risk of fractures, patients with osteogenesis imperfecta can have chest wall deformities including pectus excavatum and pectus carinatum. Cardiorespiratory problems caused by these deformities is the major cause of morbidity and mortality in these patients. Outcomes of surgical correction of pectus excavatum in patients with osteogenesis imperfecta have not been described in the literature. It is important to establish definitive treatment options for these patients to improve their respiratory capacity and reduce mortality. In this case series we present the case of two pre-pubertal pediatric patients with osteogenesis imperfecta type I who underwent surgical correction of pectus excavatum with the Nuss procedure after pamidronate therapy. Both patients had successful correction of the chest wall deformity with significant improvement in their quality of life. • Osteogenesis imperfecta is a rare genetic disorder that causes bone fragility. • Pectus excavatum can be associated with this disease, however the number of cases is limited. • Bisphosphonate therapy can be given prior to undergoing Nuss procedure in patients with osteogenesis imperfecta type I.

Currarino-Silverman syndrome: diagnosis and treatment of rare chest wall deformity, a case series.

BackgroundCurrarino-Silverman (CS) syndrome is an extremely rare congenital deformity of the anterior chest wall. The syndrome is often combined with congenital heart defects and spinal abnormalities. As of currently, there is a lack of definite description in the literature about this type of pectus deformity. Typically, patients do not require surgical intervention for medical reasons, and the correction is usually only for cosmetic purposes. The purpose of this study was to demonstrate surgical intervention for CS syndrome at a tertiary care facility, and to summarize the available literature.MethodsPatients with CS syndrome were retrospectively reviewed from a period of June 2012 to August 2019. An extensive literature search for “Currarino-Silverman syndrome,” “pouter pigeon chest,” “chondromanubrial deformity,” “type 2 pectus carinatum” and “pectus arcuatum” was performed.ResultsFour clinical cases of CS syndrome are presented, two of which were symptomatic and corrected. The procedure of choice was the modified Ravitch-type thoracoplasty with double osteotomy and implantation of support plates.ConclusionsThere is no clear definition of CS syndrome in the literature. Correct and uniform classification plays a crucial role in the surgical treatment of this pathology. Due to the extreme rarity of the disease, challenging deformity, and variable anatomy of the fused sternum, there are no clear guidelines in treatment approaches. The correction is mostly pursued only for cosmetic results, and the best surgical option for CS syndrome remains the relatively aggressive Ravitch-type procedure with multi-level wedge osteotomy.

Marfan Syndrome With Recurrent Lower Left Posterior Toothache as the First Symptom: A Report on a Rare Case

Marfan syndrome (MFS) is a life-threatening connective tissue disorder that affects multiple organs and systems. We report a case of MFS with recurrent lower left posterior toothache as the first symptom. A 23-year-old Asian man walked into the dental emergency room with a chief complaint of recurrent spontaneous and intermittent toothache in his lower left posterior tooth region, mimicking acute symptomatic pulpitis. He self-reported a relatively healthy medical status without any hereditary disease. However, his disproportionately elongated body structure, high myopia, and positive wrist sign were immediately recognizable. Although there were no remarkable findings on the dental examination, pectus carinatum deformity and abnormal blood pressure were later detected. He was immediately referred to a cardiologist in a medical hospital. The timely diagnosis of MFS and early surgical intervention helped to avoid severe lethal consequences. The symptoms of toothache completely resolved after surgery.

Komplikasyonlar Açısından Minimal İnvaziv Onarım Pektus Karinatum İçin Hangi Dönem Seçilmeli?

Background: Pectus carinatum (PC) presents with anterior protrusion of the chest wall in the childhood period and becomes more prominent during puberty. Optimum time for surgery concerns the life period with flexibility of the chest wall. However, today Abramson operation is performed for younger and adult patients by many surgeons. In this study, we aimed to compare the complication results of Abramson surgery for PC between pediatric, adolescent and adult groups, to indicate the optimal appropriate period for this surgery.Materials and Methods: From 2012 to 2018, 178 cases had symmetric-asymmetric PC identified. A total of 63 patients who could not use or had unsuccessful outcomes with a brace therapy were treated with Abramson surgery in our clinic. We classified patients into three groups: Pediatric (patients younger than 12 years), adolescent (patients between 13 and 16 years); and adult (patients between 17 and 20 years). We evaluated patients' demographics, and compared results of surgery, duration of hospitalization and complication rates.Results: Fifty patients were male and 13 were female. The age range was 8 to 20 years (mean 14.5±2.5 years). Symptomatic patients and chest pain in the preoperative period were seen more frequently in patients with older age, but this was not statistically significant (p:0.061, p:0.901, p:510). There was no significant difference between groups with respect to duration of operation, and duration of follow up (p:0.338, p:0.646, p:0.668). In the early 30-day postoperative period, no mortality was observed. In logistic regression analysis, postoperative complications increased in patients older than 17 years, but this wasn't statistically significant (p:0.256).Conclusions: The Abramson procedure is an effective and successful method with low complication rates in the group who do not benefit from a brace for treatment of pectus carinatum. However, complication rates may increase in the adult period, though this was not statistically significant.

Pectus carinatum as the key to early diagnosis of Morquio A syndrome: a case report

BackgroundA 20-month-old Asian boy with normal growth presented with genu valgum, kyphosis, and pectus carinatum, with no neurological symptoms. No other symptoms suggestive of mucopolysaccharidoses, for example joint contracture and peculiar facies, were present.Case presentationAs part of our differential diagnosis we found elevated urine glycosaminoglycans, which triggered further investigation. Detailed examination showed flattening of the ribs, kyphoscoliosis and ovalization of the thoracolumbar vertebral body, strikingly short metacarpals, and very slight cardiac regurgitation. N-Acetylgalactosamine-6-sulfatase levels in the blood and dermal fibroblasts were very low, thus confirming diagnosis of Morquio A within 2 months of presentation. The patient was placed on elosulfase alfa enzyme replacement therapy and followed for 3 years.ConclusionsThis case exemplifies the importance of considering mucopolysaccharidoses as part of the initial differential diagnosis of pediatric patients with skeletal deformities; urine glycosaminoglycan levels and a blood enzyme mucopolysaccharidoses panel are simple screening tests that could lead to early definitive diagnosis.

A RARE CAUSE OF AORTIC STENOSIS IN A SIBLING - MORQUIO SYNDROME - A CASE REPORT

Morquio syndrome is an uncommon variant of autosomal recessive disorder caused by the deficiency of N acetyl galactosamine 6 sulfatase (GALNS) - a lysosomal enzyme, causing dental, cardiac and skeletal abnormalities. A male patient, 29 years of age came with complaints of difficulty in breathing since one month. He was born of a second degree consanguineous marriage and has no mental retardation. On clinical examination he was short in stature, had corneal clouding, widely spaced teeth, genu valgum, joint hypermobility, pectus carinatum and kyphoscoliosis. He had an ejection systolic murmur in aortic area on cardiovascular examination. He has one 26 year old sister with similar physical appearance and cardiac abnormalities. In Echocardiography they both found to have aortic valve calcification with severe aortic stenosis with mild aortic regurgitation. X ray findings of the hand showed shortening of the metacarpal with hypoplasia of the carpal bones, platyspondly of the cervical and thoracic vertebra, genu valgum and coxa valga defect. So he was diagnosed as adult mucopolysaccharoidosis type IV-A (Morquio syndrome) which was confirmed after clinical examination and genetic analysis

EP293 - Homozygous PISD truncating variant in an adult patient presenting with chronic dysphagia, hoarseness, pectus carinatum, hearing loss, and hemiparesis

eP293 - Homozygous PISD truncating variant in an adult patient presenting with chronic dysphagia, hoarseness, pectus carinatum, hearing loss, and hemiparesis

Patient-Reported Efficacy of the University of California, San Francisco, Custom Pectus Carinatum Orthosis

ABSTRACT Introduction Pectus carinatum is a bony deformity of the anterior chest wall and has a strong negative impact on patient self-esteem and quality of life. During adolescence, the deformity is often flexible and can be treated with a compressive orthosis. Compliance with orthoses yields deformity correction and self-esteem improvement (J Pediatr Surg. 2013;48:1055-1059). The purpose of this study is to evaluate the compliance to and patient satisfaction with the custom University of California, San Francisco (UCSF), Pectus Carinatum Orthosis (PCO) design. Materials and Methods This was a cross-sectional survey of the patients who received orthotic treatment for pectus carinatum at UCSF between August 2012 and June 2018. Potential subjects were contacted and asked to complete the Pectus Carinatum Evaluation Questionnaire (PCEQ), which was administered online via Research Electronic Data Capture. The PCEQ measures compliance as well as the physical and psychosocial impact of orthotic treatment for pectus carinatum. Results were compiled and summarized using nonparametric descriptive statistics. Results Of the 35 consented subjects, 12 (11 male patients and 1 female patient aged 12–17 years) completed the survey. Subjects reported an average wear time of 12.7 hours per day, 5 days a week. Seven reported no symptoms, three experienced chest pain, two reported difficulty breathing, and one had back pain. Eight reported happiness with the results of their orthotic treatment. Conclusion Wear times reported by the subjects were comparable with those reported in other studies looking at prefabricated pectus orthoses. However, there were lower reports of pain associated with the UCSF treatment than in other studies. Further research is necessary to determine the benefit of custom fabricated versus prefabricated PCOs.

X-ray-free protocol for pectus deformities based on magnetic resonance imaging and a low-cost portable three-dimensional scanning device: a preliminary study.

To compare a standard protocol using chest computed tomography (CT) to a non-irradiant protocol involving a low-cost portable 3D scanner and magnetic resonance imaging (MRI) for all pectus deformities based on the Haller index (HI). From April 2019 to March 2020, all children treated for pectus excavatum or carinatum at our institution were evaluated by chest CT, 3D scanning (iPad with Structure Sensor and Captevia-Rodin4D) and MRI. The main objectives were to compare the HI determined by CT or MRI to a derived index evaluated with 3D scanning, the external Haller index (EHI). The secondary objectives were to assess the inter-rater variability and the concordance between CT and MRI for the HI and the correction index. Eleven patients were evaluated. We identified a strong correlation between the HI with MRI and the EHI (Pearson correlation coefficient = 0.900; P < 0.001), with a strong concordance between a radiologist and a non-radiologist using intra-class correlation for the HI with MRI (intra-class correlation coefficient = 0.995; [0.983; 0.999]) and the EHI (intra-class correlation coefficient = 0.978; [0.823; 0.995]). We also identified a marked correlation between the HI with CT and the EHI (Pearson coefficient = 0.855; P = 0.002), with a strong inter-rater concordance (intra-class correlation coefficient = 0.975; [0.901; 0.993]), a reliable concordance between CT and MRI for the HI and the correction index (Pearson coefficient = 0.886; P = 0.033). Non-irradiant pectus deformity assessment is possible in clinical practice, replacing CT with MRI and 3D scanning as a possible readily-accessible monitoring tool.

Orthotic Bracing or Minimally Invasive Surgery? A Summary of 767 Pectus Carinatum Cases for 9 Years.

Orthotic bracing and minimally invasive surgery are currently the treatment methods for pectus carinatum. We present our experience with the advantages, method selection criteria, and precautions for both treatment methods. A total of 767 pediatric patients (596 boys and 171 girls) with pectus carinatum were retrospectively analyzed. All of them received orthotic bracing, and 108 pediatric patients received minimally invasive surgery, achieving good outcomes. Among the 767 pediatric patients, 644 obtained satisfactory chest appearance through orthotic bracing, with a success rate of 84.0%. Younger pediatric patients had better orthotic outcomes. Among the 123 failure cases, 108 pediatric patients underwent minimally invasive surgery as the treatment. Seventy-six pediatric patients with simple chondrogladiolar prominence underwent a minimally invasive sternal depression procedure, whereas 32 pediatric patients with complex chondromanubrial prominence underwent surgery. All 108 pediatric patients successfully completed the surgery. The operation time was 112.8 ± 23.5 min, and the average length of hospital stay after the surgery was 7 days. A follow-up was conducted for at least 3 months and up to 3 years. The orthotic effect was satisfactory. For younger pediatric patients with pectus carinatum, noninvasive orthotic bracing treatment should be considered first. For older pediatric patients, the failure rate of the bracing was higher, and the outcomes were often unsatisfactory. Especially for patients over 15 years old, minimally invasive sternal depression may be the preferred treatment for pectus carinatum.

Comparison of Outcomes Between Anti-Nuss Operation and Modified Anti-Nuss Operation Using a Flexible Plate for Correcting Pectus Carinatum: A Retrospective Study.

Introduction: The anti-Nuss procedure has gradually been found to have several shortcomings in clinical practice. Accordingly, our department previously designed and introduced a new steel plate. However, there is limited evidence regarding its safety and efficacy. Thus, we aim to compare the efficacy and safety of the conventional anti-Nuss operation with those of a modified anti-Nuss operation using a flexible plate.Methods: Patients with pectus carinatum who underwent surgery between January 2014 and August 2019 were consecutively enrolled in this single-center, retrospective study. In all, 53 patients underwent the modified procedure using the new steel plate (new procedure group), whereas 43 underwent the conventional anti-Nuss procedure (traditional procedure group). Outcome analysis was performed using SPSS to compare the intraoperative and postoperative short-term outcomes.Results: All patients in the new procedure group had shorter operation duration (75.23 ± 11.90 vs. 82.45 ± 9.30 min, p = 0.008), postoperative hospitalizations (3.42 ± 0.95 vs. 4.64 ± 1.53 days, p = 0.039), and plate removal surgery durations (40.60 ± 3.47 vs. 60.30 ± 9.75 min, p = 0.041) than patients in the traditional procedure group. There were no significant differences in the length of incision, postoperative Haller index, cost, postoperative surgical outcome, and incidence of complications between the two groups.Conclusion: Our data reveal that the main clinical outcomes were similar for after anti-Nuss operation and modified anti-Nuss operation. However, the modified procedure for pectus carinatum had a shorter operation duration, postoperative hospitalization, and plate removal surgery duration.