Lung Function after the Minimal Invasive Pectus Excavatum Repair (Nuss Procedure)
The Nuss procedure was introduced at our center in 1999. The operation was mainly performed for cosmesis. Little information is available regarding the influence of this operation on lung function.
The aim of this study, a prospective analysis, was to analyze the effect of the Nuss procedure on lung function variables. Between 1999 and 2007 a total of 203 patients with pectus excavatum were treated with the Nuss procedure, of whom 145 (104 male, 41 female) were located at Emma Children’s Hospital. In the latter subset of consecutive patients, static lung function variables [total lung capacity (TLC), functional residual capacity (FRC), vital capacity (VC)] and dynamic lung function variables [forced expired volume in 1 s (FEV1), maximum expiratory flow (MEF50)] were performed using spirometry and body box measurements at four time points: prior to operation (T0), 6 months after the Nuss procedure (T1, n = 111), prior to removal of the Nuss bar (T2, n = 74), and 6 months after removal (T3, n = 53). All values were expressed as a percent of normal values for sex, age, and height. Results were compared with a paired-samples t-test, with the level of significance at p = 0.05.
At 6 months after bar insertion the TLC, FRC, VC, FEV1, and MEF50 showed a significant increase; and prior to bar removal the FRC and MEF50 showed significantly increased values. At 6 months after Nuss bar removal, none of the lung function variables showed any significant change compared to the preoperative values.
After the Nuss procedure for pectus excavatum, there was no improvement of pulmonary function, but neither was the patient’s pulmonary function harmed by resolving a largely cosmetic problem.
- Ravitch MM (1949) The operative repair of pectus excavatum. Ann Surg 129:429–444 CrossRef
- Castile R, Staats BA, Westbrook PR (1982) Symptomatic pectus deformities of the chest. Am Rev Respir Dis 126:564–568
- Derveaux L, Clarysse I, Ivanoff I, et al. (1989) Preoperative and postoperative abnormalities in chest x-ray indices and in lung function in pectus deformities. Chest 95:850–856
- Morshuis W, Folgering H, Barentsz J, et al. (1994) Pulmonary function before surgery for pectus excavatum and at long-term follow-up. Chest 105:1646–1652
- Quigley PM, Haller JA Jr, Jelus KL, et al. (1996) Cardiorespiratory function before and after corrective surgery in pectus excavatum. J Pediatr 128:638–643 CrossRef
- Cahill JL, Lees GM, Robertson HT (1984) A summary of preoperative and postoperative cardiorespiratory performance in patients undergoing pectus excavatum and carinatum repair. J Pediatr Surg 19:430–433 CrossRef
- Nuss D, Kelly RE, Croitoru DP, et al. (1998) A 10 years review of a minimally invasive technique for correction of pectus excavatum. J Pediatr Surg 33:545–552 CrossRef
- Sigalet DL, Montgomery M, Harder J (2003) Cardiopulmonary effects of closed repair of pectus excavatum. J Pediatr Surg 38:380–385 CrossRef
- Borowitz D, Zallen G, Sharp J, et al. (2003) Pulmonary function and response to exercise following Nuss repair in patients with pectus excavatum. J Pediatr Surg 38:544–547 CrossRef
- Lawson ML, Mellins RB, Tabangin M, et al. (2005) Impact of pectus excavatum on pulmonary function before and after repair with the Nuss procedure. J Pediatr Surg 40:174–180 CrossRef
- Zapletal A, Samanek M, Paul T (1987) Lung function in children and adolescents: methods, reference values. Prog Respir Res 22:114–218
- Malek MH, Fonkalsrud EW, Cooper CB (2003) Ventilatory and cardiovascular responses to exercise in patients with pectus excavatum. Chest 124:870–882 CrossRef
- Coln E, Carrasco J, Coln D (2006) Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum. J Pediatr Surg 41:683–686 CrossRef
- Beiser G, Epstein SE, Stampfer M, et al. (1972) Impairment of cardiac function in patients with pectus excavatum with improvement after operative correction. N Engl J Med 99:41–47
- Haller JA, Loughlin GM (2000) Cardiorespiratory function is significantly improved following corrective surgery for severe pectus excavatum. J Cardiovasc Surg 41:125–130
- Shamburger RC (2000) Cardiopulmonary effects of anterior chest wall deformities. Chest Surg Clin N Am 10:245–252
- Lung Function after the Minimal Invasive Pectus Excavatum Repair (Nuss Procedure)
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
World Journal of Surgery
Volume 31, Issue 7 , pp 1518-1522
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Pediatric Surgical Center of Amsterdam, Emma Children’s Hospital AMC and VU Medical Center, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
- 2. Department of Special Education, Vrije Universiteit Amsterdam, vd Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands
- 3. Laboratory of Clinical Lung Fysiology, Academic Medical Center, 1100, DE, Amsterdam, The Netherlands
- 4. Division of Pediatric Pulmonology, Emma Children’s Hospital AMC, Academic Medical Center, Amsterdam, The Netherlands