Materiały źródłowe

• #1 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #2 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  Pectus defects are a group of congenital conditions found in approximately 1 in 250 people, where the sternum is depressed back towards the spine (excavatum), protrudes forwards (carinatum) or more rarely is a mixture of both (arcuatum or mixed defects). […] The majority of defects are mild and are well tolerated, i.e. they do not affect activity and do not cause psychological harm. However, some young people develop lower self-esteem and depression, causing them to withdraw from activities (such as swimming, dancing) and from interactions that might 'expose’ them (such as sleepovers, dating, going to the beach and wearing fashionable clothes). […] This psychological harm occurs at a crucial time during their physical and social development. A small number of patients have more extreme depression of their sternum that impedes their physiological reserve, which can occur when engaging in strenuous exercise (such as running) but can also limit moderate activity such as walking and climbing stairs.

• #3 Pectus Excavatum | Sunken Chest Surgery | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/pectus-excavatum/

  Pectus excavatum, also known as sunken chest or funnel chest, is the most frequent congenital anomaly of the chest wall, occurring in 1 in 400 births, and is found in 2.6 percent of children aged 714. […] Funnel chest may cause children to sometimes feel shortness of breath or experience exercise intolerance or palpitations, interfering with heart and lung function. […] Although the initial care may include monitoring a patients growth and chest-specific physical therapy, surgical correction may be provided. […] If your child is an appropriate candidate for surgery, it is likely they will have either the Ravitch procedure or the minimally invasive Nuss procedure. […] It is important to take very good care of the surgical site until it is fully healed. […] In terms of resuming normal activity, patients are generally advised to abstain from heavy physical exertion for about 6 weeks. […] Routine post-surgical follow-up with your pediatric surgeon and team is important and should be done at regular intervals for up to two years post-surgery.

• #4 Pectus Excavatum – Chest Wall – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/services/chest-wall/pectus-excavatum.html

  Pectus excavatum may become more severe or apparent during periods of rapid growth. […] Early evaluation by a pediatric surgeon during the prepubertal period is helpful for families to gain an understanding of what to expect as their child matures and when intervention is optimal. […] We are pleased to offer this uncommon yet effective nonsurgical treatment option for mild to moderate pectus excavatum. […] The vacuum bell must be applied at regular intervals, eventually up to two hours each session, twice daily. […] Managing your child’s pain is very important to us. […] That’s why we offer state-of-the-art pain control techniques, including cryoablation and others to reduce pain and recovery time after surgery. […] The bar is generally removed between two to four years after the procedure and can be completed on an outpatient basis under general anesthesia.

• #5

  https://umiamihealth.org/en/treatments-and-services/surgery/thoracic-surgery/pectus-excavatum

  Pectus excavatum and pectus carinatum are chest wall deformities that happen when several ribs and the breastbone grow abnormally. They cause the chest to sink inward or push outward. For many people with either condition, the only symptom is the chest’s appearance. […] Although both may be noticeable at birth, sometimes they aren’t apparent until a child’s growth spurt during puberty when the chest wall sinks or juts out more significantly. It’s best to get treatment at this time before puberty is complete. After puberty, the chest wall is more rigid and more difficult to reposition. […] Pectus excavatum, also called funnel chest, causes the chest to sink inward. More severe cases can press on the heart and lungs, which may cause rapid heartbeats or palpitations (arrhythmias), frequent respiratory infections, or difficulty breathing especially during exercise and dizziness.

• #6 Pectus Excavatum – MU Health Care

  https://www.muhealth.org/conditions-treatments/pediatrics/general-surgery/chest-wall-deformities/pectus-excavatum

  Pectus excavatum also known as sunken chest or funnel chest occurs when an abnormal growth of cartilage within the chest wall pushes the sternum and ribs inward, creating a caved-in or sunken appearance. […] Depending on its severity, pectus excavatum might cause your child to experience chest discomfort, shortness of breath, decreased physical stamina and endurance, and heart palpitations, especially during exercise. It could also cause your child to feel self-conscious or anxious about their appearance. […] Initial care might include monitoring your child’s growth and chest-specific physical therapy. Our team will provide you with a list of chest wall and arm exercises that are helpful in reshaping the chest and strengthening the muscle groups involved. However, over time, surgical correction is frequently recommended.

• #7 Pectus excavatum – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/care-at-mayo-clinic/mac-20355491

  Pectus excavatum care at Mayo Clinic […] Patients can breathe better after having this corrected it also improves their self-esteem. […] And because we’ve added cryotherapy to our pain management program, we’ve gone from a four to five day hospital stay now to an overnight procedure so people can come in have their surgery and go home the next day. […] We use a minimally invasive cryoablation probe to freeze the intercostal nerves temporarily which results in patients having a very low or no opioid requirement after surgery. […] Ultimately our goal is to get them back home and getting them back to a happy healthy life. […] Specialists in cardiology, pulmonary medicine, thoracic surgery and rehabilitation medicine work together to develop the best treatment plan for you or your child.

• #8 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  The Pectus and Chest Wall Treatment Program evaluates and treats children and young adults with a wide variety of chest wall deformities. As one of the busiest chest wall treatment programs in the country, we have deep experience in all levels of care: from nonsurgical treatment to minimally invasive surgery, or — when clinically necessary — open surgery. Thanks to our extensive experience, we can ensure each of our patients receives the most appropriate care for their condition. […] Our multi-disciplinary team includes surgeons, nurses, and nurse practitioners, as well as pain management anesthesiologists, certified orthotists, pulmonologists, and cardiologists. And because we are part of Boston Children’s Hospital, ranked among the country’s best hospitals by U.S. News & World Report, our patients have access to a full range of specialized skills and resources to meet their clinical needs.

• #9 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #10 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Pectus excavatum is the most common congenital chest wall anomaly, the hallmark of which is the caved-in appearance of the anterior chest. […] The primary objectives of this review are to outline the current practices surrounding the care of pediatric patients with pectus excavatum and present emerging trends in the field that continue to impact the care of these patients. […] This review highlights contemporary management principles of pectus excavatum in the pediatric population, comprising preoperative evaluation, surgical and non-surgical treatment, postoperative considerations including pain control, and monitoring strategies. […] This review also features updated content on non-invasive monitoring and treatment approaches such as three-dimensional (3D) scanning and vacuum bell therapy, which may alter the treatment landscape for pectus excavatum in order to reduce radiation exposure and invasive procedures when able.

• #11 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  Pectus defects are a group of congenital conditions found in approximately 1 in 250 people, where the sternum is depressed back towards the spine (excavatum), protrudes forwards (carinatum) or more rarely is a mixture of both (arcuatum or mixed defects). […] The majority of defects are mild and are well tolerated, i.e. they do not affect activity and do not cause psychological harm. However, some young people develop lower self-esteem and depression, causing them to withdraw from activities (such as swimming, dancing) and from interactions that might 'expose’ them (such as sleepovers, dating, going to the beach and wearing fashionable clothes). […] This psychological harm occurs at a crucial time during their physical and social development. A small number of patients have more extreme depression of their sternum that impedes their physiological reserve, which can occur when engaging in strenuous exercise (such as running) but can also limit moderate activity such as walking and climbing stairs.

• #12 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  The decision to treat is ultimately guided by the patients perception of cosmetic discomfort and supported by measures such as severity index and markers of physiologic compromise. […] This review addresses components of pectus excavatum management, including preoperative considerations, surgical and non-surgical techniques, postoperative pain control, and patient monitoring strategies, with emphasis on novel or emerging approaches when relevant. […] Surgical correction of pectus excavatum is typically recommended if a patient experiences cosmetic discomfort with their chest, and meets two or more of the following criteria: chest CT or MRI showing cardiac or pulmonary compression with HI of 3.25 or greater, restrictive lung disease by PFT evaluation, cardiac conduction abnormalities, performance abnormalities, or recurrence of pectus excavatum following open or closed surgical intervention.

• #13 Pectus Excavatum – MU Health Care

  https://www.muhealth.org/conditions-treatments/pediatrics/general-surgery/chest-wall-deformities/pectus-excavatum

  Pectus excavatum also known as sunken chest or funnel chest occurs when an abnormal growth of cartilage within the chest wall pushes the sternum and ribs inward, creating a caved-in or sunken appearance. […] Depending on its severity, pectus excavatum might cause your child to experience chest discomfort, shortness of breath, decreased physical stamina and endurance, and heart palpitations, especially during exercise. It could also cause your child to feel self-conscious or anxious about their appearance. […] Initial care might include monitoring your child’s growth and chest-specific physical therapy. Our team will provide you with a list of chest wall and arm exercises that are helpful in reshaping the chest and strengthening the muscle groups involved. However, over time, surgical correction is frequently recommended.

• #14 Pectus Excavatum – Birth Defect Fact Sheet

  https://birthdefects.org/pectus-excavatum/

  Pectus Excavatum is the most common chest wall deformity seen in children. PE is also called sunken chest or funnel chest. It is a abnormality of the chest characterized by depression of the lower part of the sternum (breastbone) caused by an overgrowth of cartilage between the ribs and the sternum pushing inward. The most recessed or deepest area is most often the point where the chest and abdomen meet. More severe depressions can cause the heart to be displaced to the left and cause pressure on the pulmonary artery, which carries blood from the heart to the lungs. […] Children with mild cases of PE may never experience any symptoms. More severe cases of Pectus Excavatum may cause symptoms when the child participates in athletic or other high-stress, physical activity. Older children with more severe Pectus Excavatum may begin to experience easy fatigability and decreased stamina and endurance.

• #15 Pectus Excavatum | Sunken Chest Surgery | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/pectus-excavatum/

  Pectus excavatum, also known as sunken chest or funnel chest, is the most frequent congenital anomaly of the chest wall, occurring in 1 in 400 births, and is found in 2.6 percent of children aged 714. […] Funnel chest may cause children to sometimes feel shortness of breath or experience exercise intolerance or palpitations, interfering with heart and lung function. […] Although the initial care may include monitoring a patients growth and chest-specific physical therapy, surgical correction may be provided. […] If your child is an appropriate candidate for surgery, it is likely they will have either the Ravitch procedure or the minimally invasive Nuss procedure. […] It is important to take very good care of the surgical site until it is fully healed. […] In terms of resuming normal activity, patients are generally advised to abstain from heavy physical exertion for about 6 weeks. […] Routine post-surgical follow-up with your pediatric surgeon and team is important and should be done at regular intervals for up to two years post-surgery.

• #16 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  Pectus defects are a group of congenital conditions found in approximately 1 in 250 people, where the sternum is depressed back towards the spine (excavatum), protrudes forwards (carinatum) or more rarely is a mixture of both (arcuatum or mixed defects). […] The majority of defects are mild and are well tolerated, i.e. they do not affect activity and do not cause psychological harm. However, some young people develop lower self-esteem and depression, causing them to withdraw from activities (such as swimming, dancing) and from interactions that might 'expose’ them (such as sleepovers, dating, going to the beach and wearing fashionable clothes). […] This psychological harm occurs at a crucial time during their physical and social development. A small number of patients have more extreme depression of their sternum that impedes their physiological reserve, which can occur when engaging in strenuous exercise (such as running) but can also limit moderate activity such as walking and climbing stairs.

• #17 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  Pectus defects are a group of congenital conditions found in approximately 1 in 250 people, where the sternum is depressed back towards the spine (excavatum), protrudes forwards (carinatum) or more rarely is a mixture of both (arcuatum or mixed defects). […] The majority of defects are mild and are well tolerated, i.e. they do not affect activity and do not cause psychological harm. However, some young people develop lower self-esteem and depression, causing them to withdraw from activities (such as swimming, dancing) and from interactions that might 'expose’ them (such as sleepovers, dating, going to the beach and wearing fashionable clothes). […] This psychological harm occurs at a crucial time during their physical and social development. A small number of patients have more extreme depression of their sternum that impedes their physiological reserve, which can occur when engaging in strenuous exercise (such as running) but can also limit moderate activity such as walking and climbing stairs.

• #18 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  The effects can be so extreme that symptoms occur at rest or cause life-threatening compression of the major blood vessels and organs. The group of patients with physiological impairment usually also suffer from low self-esteem and depression. […] This paper summarizes the current evidence for the different treatment strategies for this condition, including supportive care, psychological support and non-surgical techniques including bracing and vacuum bell therapy. […] For the majority of patients, supportive care is sufficient, but for a minority, a combination of the other techniques may be considered. […] This paper also outlines best practice guidance for the delivery of such therapies, including standardized assessment, consent to treatment, audit, quality assurance and long-term support. […] All the interventions have risks and benefits that the patient, parents and clinicians need to carefully consider and discuss when deciding on the most appropriate course.

• #19 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  We understand that every child is different. Because of this, getting to know each patient, their goals and interests, and how their chest wall affects their daily life is an essential part of care at Boston Children’s. […] From diagnosis to treatment planning and each stage of care, we work to ensure our patients and their families have the best possible experience. This includes making sure we answer all of our patients’ and families’ questions, providing the least invasive treatment options, and — when a patient needs surgery — offering effective pain management and services for a safe return to activity. […] For many children with mild to moderate pectus excavatum or pectus carinatum, vacuum bell therapy or bracing can make surgery unnecessary. We now initiate care with these non-operative techniques and only recommend surgery if the condition persists after treatment. Boston Children’s is one of the first hospitals to offer this plan of care.

• #20 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #21 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  The effects can be so extreme that symptoms occur at rest or cause life-threatening compression of the major blood vessels and organs. The group of patients with physiological impairment usually also suffer from low self-esteem and depression. […] This paper summarizes the current evidence for the different treatment strategies for this condition, including supportive care, psychological support and non-surgical techniques including bracing and vacuum bell therapy. […] For the majority of patients, supportive care is sufficient, but for a minority, a combination of the other techniques may be considered. […] This paper also outlines best practice guidance for the delivery of such therapies, including standardized assessment, consent to treatment, audit, quality assurance and long-term support. […] All the interventions have risks and benefits that the patient, parents and clinicians need to carefully consider and discuss when deciding on the most appropriate course.

• #22 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #23 Chest Wall Disorder: Pectus Excavatum (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/pectus-excavatum.html

  Kids with pectus excavatum will need treatment if they have symptoms or are bothered by how their chest looks. There are a few options to fix the shape of the chest. […] Doctors also might suggest physical therapy and exercises. These can make the chest muscles stronger and improve posture. […] All kids with pectus excavatum should be seen by a chest wall surgeon. The condition can cause problems even when it doesn’t look very severe from the outside. Most kids and teens who have treatment do very well and are happy with the results.

• #24 Pectus Excavatum | Sunken Chest Surgery | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/pectus-excavatum/

  Pectus excavatum, also known as sunken chest or funnel chest, is the most frequent congenital anomaly of the chest wall, occurring in 1 in 400 births, and is found in 2.6 percent of children aged 714. […] Funnel chest may cause children to sometimes feel shortness of breath or experience exercise intolerance or palpitations, interfering with heart and lung function. […] Although the initial care may include monitoring a patients growth and chest-specific physical therapy, surgical correction may be provided. […] If your child is an appropriate candidate for surgery, it is likely they will have either the Ravitch procedure or the minimally invasive Nuss procedure. […] It is important to take very good care of the surgical site until it is fully healed. […] In terms of resuming normal activity, patients are generally advised to abstain from heavy physical exertion for about 6 weeks. […] Routine post-surgical follow-up with your pediatric surgeon and team is important and should be done at regular intervals for up to two years post-surgery.

• #25 Pectus Excavatum vs. Pectus Carinatum

  https://www.cookchildrens.org/services/pediatric-surgery/specialty-programs/pectus-excavatum-carinatum/

  For children with pectus excavatum, chest wall deformities may range from mild to severe. Mild cases might be barely noticeable. Pectus excavatum can be completely harmless, but the visual appearance can affect a child’s self-image, and they may also be subjected to teasing and even bullying. Severe cases can cause a deep hollow in the chest and may affect the heart and lungs. Surgery can often correct the condition and treat any heart or lung issues. […] Treatment of mild pectus excavatum may consist of exercises for improving posture and upper body strength. If your child has moderate to severe pectus excavatum, surgery may be recommended. […] For mild deformities, posture control, exercise program (e.g., deep breathing, pushups) and annual follow-up may be appropriate. Many patients are candidates for this non-operative treatment before considering surgical repair. Compliance is important for optimal results.

• #26 Pectus Excavatum – MU Health Care

  https://www.muhealth.org/conditions-treatments/pediatrics/general-surgery/chest-wall-deformities/pectus-excavatum

  In less severe cases, we offer a nonsurgical treatment called the vacuum bell. This is essentially a large suction cup that creates a vacuum seal on your child’s chest wall and lifts the sternum, correcting pectus excavatum over time. […] Our team utilizes an innovative approach to post-operative pain relief using cryoablation. During this procedure, a probe is inserted into the chest using small incisions and temporarily freezes the nerves. Minimal numbness in the chest wall may last up to six months. […] When your child is awake in the recovery room, our nursing team and anesthesiologist work together to ensure he or she is as comfortable as possible. Your child will receive a combination of intravenous (IV) and oral pain medications, muscle relaxants and local anesthetic patches after surgery. We use minimal narcotic pain medications. […] Using these innovative approaches, the average hospital length of stay is usually 2-3 days.

• #27 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  Vacuum bell therapy uses a device placed on the chest of a child with pectus excavatum. The device creates suction that slowly pulls the breastbone forward over time. […] We utilize cryoablation during surgery to help minimize post-operative pain. Cryoablation uses cold temperatures to reduce the pain signals sent to the brain. This method of pain management has been proven to reduce the length of patients’ hospital stays, decrease the need for narcotic pain medication, and improve recovery time. […] Patient safety and comfort are our top priorities anytime a chest wall issue requires surgical treatment. We use state-of-the-art equipment in the operating room to ensure your child has the best possible outcome with the lowest possible risk. […] Well before a scheduled surgery, our anesthesiologists meet with our patients and their families to agree on a pain management plan that both the patient and family are comfortable with. During and after the operation, our team of pediatric anesthesiologists work to control pain so that your child has a smooth, comfortable recovery.

• #28 Pectus Excavatum | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/pectus-excavatum

  Pectus excavatum, also known as concave chest or funnel chest, is a chest wall deformity in which a child’s breastbone (sternum) and some of the ribs grow inward. This causes a depression in the middle of the chest. […] Many children with mild pectus excavatum don’t require treatment. […] If pectus excavatum is causing your child physical or social problems, there are treatment options. At Boston Children’s, we typically start with non-surgical treatment and only recommend surgery if that is the only option to correct the shape of the chest. […] Vacuum bell therapy uses a device worn on the outside of the body and creates suction to lift the breastbone forward over time. […] If your child’s pectus excavatum is more severe or does not improve with vacuum bell therapy, there are two surgical options to correct the shape of the chest.

• #29 Pectus excavatum from a pediatric surgeon’s perspective – Nuss- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/11847/html

  Asymptomatic patients who are judged to have a mild or moderate deformity are treated conservatively. The conservative treatment program consists of two parts: […] Firstly, the patients are started on deep breathing with breath holding exercises and a posture program. These patients are also encouraged to participate in aerobic sports activities. It is very important that the physician closely monitors the patients and that the parents take responsibility to ensure that the exercise program is properly carried out, otherwise there is almost universal failure to comply. […] Secondly, patients may be offered vacuum bell therapy which requires a 1 to 2 year commitment. This requires careful instruction in the clinic and if the patient is too young to be held responsible, then the parents need to supervise the application at home. Once again, compliance with the physician directed program on a daily basis is absolutely essential for optimal results.

• #30 Pectus Excavatum – Birth Defect Fact Sheet

  https://birthdefects.org/pectus-excavatum/

  The pressure placed by the depression on the pulmonary artery decreases blood flow from the heart to the lungs. This lack of blood flow, in turn causes a lack of oxygen, responsible for the fatigue and lack of endurance. […] If the chest depression is not severe and your child has no physical symptoms, exercise programs such as martial arts, gymnastics, swimming, yoga or other orthopedic programs may help to improve the physical appearance of the chest. However, if your child has a more severe case of Pectus Excavatum, strenuous physical activity could worsen the condition.

• #31 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  The decision to treat is ultimately guided by the patients perception of cosmetic discomfort and supported by measures such as severity index and markers of physiologic compromise. […] This review addresses components of pectus excavatum management, including preoperative considerations, surgical and non-surgical techniques, postoperative pain control, and patient monitoring strategies, with emphasis on novel or emerging approaches when relevant. […] Surgical correction of pectus excavatum is typically recommended if a patient experiences cosmetic discomfort with their chest, and meets two or more of the following criteria: chest CT or MRI showing cardiac or pulmonary compression with HI of 3.25 or greater, restrictive lung disease by PFT evaluation, cardiac conduction abnormalities, performance abnormalities, or recurrence of pectus excavatum following open or closed surgical intervention.

• #32

  https://umiamihealth.org/en/treatments-and-services/surgery/thoracic-surgery/pectus-excavatum

  If you’re looking for treatment for yourself or your child, you can count on the experts at UHealth. We explain all your options to help you decide what’s right for you. Our surgeons use the latest approaches and minimally invasive procedures to treat both children and adults. You get comprehensive care from a highly skilled, experienced team. […] Chest Bracing for Pectus Carinatum: Children whose bones are still growing can wear a chest brace to press the breastbone back into position. They wear the brace for up to 23 hours a day. Depending on the breastbone’s position, a child may wear the brace for six months to a year. If the pectus carinatum is severe, your doctor may recommend surgery. […] Nuss Procedure for Pectus Excavatum: This minimally invasive procedure, called video-assisted thoracoscopic surgery (VATS), uses two small cuts on each side of the chest and another small cut to insert a tiny camera that lets your surgeon see inside your chest. Your surgeon places one or more curved metal bars under your breastbone to push it into the correct position. The bars stay there for two or three years to reshape your breastbone into place, and then they’re removed.

• #33 NUSS Procedure | Pectus Excavatum Surgery | CHOC – Sunken Chest Surgery, Recovery & Survival Rates

  https://choc.org/programs-services/pediatric-general-surgery/pectus-excavatum-sunken-chest-nuss/

  Pectus excavatum, commonly referred to as “sunken chest,” is when the breastbone, or sternum, and some of the ribs grow abnormally and cause a depression in the middle of the chest. It is the most common congenital chest wall abnormality in children. […] If the depression of the chest wall is severe, it can push down on the heart and lungs and makes it hard for them to work properly. If the abnormality is severe, pectus excavatum surgery may be recommended to correct the deformity and eliminate many symptoms such as shortness of breath, difficulty breathing during exercise, chest pain and even episodes of light-headedness. The pediatric surgeons at CHOC in Orange County, California, specialize in performing a minimally invasive procedure, known as the Nuss procedure, to repair pectus excavatum in minimal recovery time.

• #34

  https://umiamihealth.org/en/treatments-and-services/surgery/thoracic-surgery/pectus-excavatum

  Ravitch Procedure: This open surgery approach may be used for more severe cases of pectus excavatum when the Nuss approach isn’t possible or for pectus carinatum when bracing isn’t an option. Using a larger cut in the center of the chest, your surgeon removes the deformed cartilage causing the deformity and repositions the breastbone. If the procedure is for pectus excavatum, the surgeon may insert a metal bar to hold the breastbone in position.

• #35 Pectus Excavatum | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/pectus-excavatum

  Pectus excavatum can compromise lung and heart capacity, especially when the condition is severe, causing fatigue, shortness of breath, chest pain, and a fast heartbeat. […] The ideal age for surgical treatment of pectus excavatum is between 12 and 18 years. The goal of surgery to correct a pectus excavatum defect is to improve breathing, posture, and cardiac function, in addition to giving the chest a normal appearance. This is typically accomplished by repositioning the breastbone. Surgical repair has excellent success rates and oftentimes, cardiovascular and lung function returns to near normal in the majority of cases. […] Recovery after pectus excavatum repair varies depending on the persons age and the amount of chest depression. After surgery, most people leave the hospital within 3 to 5 days and can return to school or work within two to three weeks. One must avoid vigorous exercise for the first month after surgery, and contact sports for three months after surgery.

• #36 pectus excavatum | Dayton Children’s Hospital

  https://www.childrensdayton.org/patients-visitors/services/pediatric-surgery/programs-and-services/chest-wall-malformations-center

  Pectus excavatum can cause limitations to exercise and other physical activities or be completely harmless if it’s not affecting how the lungs or heart work. […] Surgery often can correct the condition and treat any heart or lung issues. Physical therapy and exercises to strengthen muscles are also helpful. […] The surgery team at Dayton Children’s has the experience, skill and modern equipment to treat patients with pectus excavatum. […] Designed for the non-surgical treatment of pectus excavatum, a vacuum bell is placed on the front of the chest and a pump is used to such the air out of the device. This creates suction, or a vacuum, that pulls the chest and breastbone forward. Over time, the chest wall and breastbone stay forward on their own and hold a new shape. […] To repair pectus excavatum, appropriate patients may undergo surgery that involves the Nuss procedure. The Nuss procedure involves placing a steel bar under the sternum to exert pressure to correct the chest deformity. The procedure itself is minimally invasive and requires two small incisions. The bar is removed two or three years later, once the deformity has corrected itself and becomes permanent. Ideally, this surgery is performed on patients ages 12-14. Any younger and the procedure would have to be repeated, and much older, the bones have hardened, making correction more difficult.

• #37 Pre and post operative care in the new surgical treatment of the Pectus Excavatum: Pectus Up – Pectus Up

  https://pectusup.com/en/pre-post-operative-care-pectus-up/

  Preparation for surgery with Pectus Up […] Postoperative care and supervision are important when the patient has undergone surgical treatment of Pectus Excavatum. […] Care should be taken with personal hygiene to avoid possible infections. […] The wound may not be touched or wet. In addition, the dressing should not be lifted until the first check-up by the surgeon. […] It is advisable to sleep on your back and avoid being on your side during sleep (at least during the first 3 months). […] You must maintain a good trunk position and avoid exposing yourself to risky situations. […] Absolute rest for about a week after the intervention. […] Activities which might be performed will always depend on the evolution of each patient and the recommendations of the surgeon. […] Perform gentle breathing exercises on a daily basis during the first fifteen days of the intervention, such as gently inspiring until the chest is completely filled; then exhale slowly until the lung is empty of air.

• #38 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  The decision to treat is ultimately guided by the patients perception of cosmetic discomfort and supported by measures such as severity index and markers of physiologic compromise. […] This review addresses components of pectus excavatum management, including preoperative considerations, surgical and non-surgical techniques, postoperative pain control, and patient monitoring strategies, with emphasis on novel or emerging approaches when relevant. […] Surgical correction of pectus excavatum is typically recommended if a patient experiences cosmetic discomfort with their chest, and meets two or more of the following criteria: chest CT or MRI showing cardiac or pulmonary compression with HI of 3.25 or greater, restrictive lung disease by PFT evaluation, cardiac conduction abnormalities, performance abnormalities, or recurrence of pectus excavatum following open or closed surgical intervention.

• #39 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  Vacuum bell therapy uses a device placed on the chest of a child with pectus excavatum. The device creates suction that slowly pulls the breastbone forward over time. […] We utilize cryoablation during surgery to help minimize post-operative pain. Cryoablation uses cold temperatures to reduce the pain signals sent to the brain. This method of pain management has been proven to reduce the length of patients’ hospital stays, decrease the need for narcotic pain medication, and improve recovery time. […] Patient safety and comfort are our top priorities anytime a chest wall issue requires surgical treatment. We use state-of-the-art equipment in the operating room to ensure your child has the best possible outcome with the lowest possible risk. […] Well before a scheduled surgery, our anesthesiologists meet with our patients and their families to agree on a pain management plan that both the patient and family are comfortable with. During and after the operation, our team of pediatric anesthesiologists work to control pain so that your child has a smooth, comfortable recovery.

• #40 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  The effects can be so extreme that symptoms occur at rest or cause life-threatening compression of the major blood vessels and organs. The group of patients with physiological impairment usually also suffer from low self-esteem and depression. […] This paper summarizes the current evidence for the different treatment strategies for this condition, including supportive care, psychological support and non-surgical techniques including bracing and vacuum bell therapy. […] For the majority of patients, supportive care is sufficient, but for a minority, a combination of the other techniques may be considered. […] This paper also outlines best practice guidance for the delivery of such therapies, including standardized assessment, consent to treatment, audit, quality assurance and long-term support. […] All the interventions have risks and benefits that the patient, parents and clinicians need to carefully consider and discuss when deciding on the most appropriate course.

• #41 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  We understand that every child is different. Because of this, getting to know each patient, their goals and interests, and how their chest wall affects their daily life is an essential part of care at Boston Children’s. […] From diagnosis to treatment planning and each stage of care, we work to ensure our patients and their families have the best possible experience. This includes making sure we answer all of our patients’ and families’ questions, providing the least invasive treatment options, and — when a patient needs surgery — offering effective pain management and services for a safe return to activity. […] For many children with mild to moderate pectus excavatum or pectus carinatum, vacuum bell therapy or bracing can make surgery unnecessary. We now initiate care with these non-operative techniques and only recommend surgery if the condition persists after treatment. Boston Children’s is one of the first hospitals to offer this plan of care.

• #42 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #43 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  Pectus defects are a group of congenital conditions found in approximately 1 in 250 people, where the sternum is depressed back towards the spine (excavatum), protrudes forwards (carinatum) or more rarely is a mixture of both (arcuatum or mixed defects). […] The majority of defects are mild and are well tolerated, i.e. they do not affect activity and do not cause psychological harm. However, some young people develop lower self-esteem and depression, causing them to withdraw from activities (such as swimming, dancing) and from interactions that might 'expose’ them (such as sleepovers, dating, going to the beach and wearing fashionable clothes). […] This psychological harm occurs at a crucial time during their physical and social development. A small number of patients have more extreme depression of their sternum that impedes their physiological reserve, which can occur when engaging in strenuous exercise (such as running) but can also limit moderate activity such as walking and climbing stairs.

• #44 Pectus Treatment Program | Pectus Excavatum / Carinatum | CHOC – Pigeon Chest & Funnel Chest Surgery and Procedures

  https://choc.org/programs-services/pediatric-general-surgery/pectus-treatment-program/

  Going through a surgical procedure can be overwhelming. That is why CHOC programs are dedicated to supporting families every step of the way. Our pectus program coordinator, Jacqueline Hurley, will guide families and pectus patients through the treatment process. She helps arrange all medical care, travel plans, appointments and more – she is a complete resource. Thanks to Jacqueline, families at CHOC’s Pectus Treatment Program receive unmatched individualized care. […] The various pediatric experts at CHOC will work together to develop an individualized treatment plan for your child. Through our program, your child will be provided with the exact care they need at the right time.

• #45 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #46 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  After a Nuss procedure you will be hospitalized for 2 – 3 days. Immediate mobilization is important and the staff will help and support you. […] The nursing staff and the physiotherapist will help and instruct you regarding how best to move, bearing in mind your restrictions. […] During hospitalization the nurse will help you look after the dressing and if necessary change it. […] You will be talking to the staff about pain relief several times a day, so we can adapt it to your needs. […] You may have difficulty urinating on your own the first few times, and it may be necessary for us to help you use a disposable catheter the first couple of times, until you can urinate on your own again. […] Whilst you are receiving analgesics and are not moving about as normal you will need a laxative to keep your bowel moving.

• #47 Pectus Excavatum | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pectus-excavatum

  Pectus excavatum is a congenital chest wall deformity that is caused by growth abnormality of the cartilage that connects the ribs to the breastbone (sternum). This causes a depression of the sternum and the chest has a sunken in or funnel chest appearance. […] The treatment of pectus excavatum is dependent upon the severity of the defect and your child’s symptoms. In most cases, surgery is not indicated. At CHOP, we offer two different treatments for pectus excavatum. We may recommend observation for mild to moderate cases and surgery for more severe or complex cases. Early referral to a pediatric surgeon is important to determine surgical options and optimize treatment. […] After surgery, your child will stay in the hospital for a few days to recover. The length of stay will depend largely on pain management. Our dedicated Pain Management Program team will help make sure your child’s pain is controlled. They will also begin physical therapy, which is important to promote recovery and movement, regain strength, expand the lungs, promote bowel function, and prevent possible complications.

• #48 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Pectus excavatum is a congenital disorder which causes the chest to have a sunken or „caved in” appearance. […] Some children with pectus excavatum report that they have chest pain and shortness of breath or limited stamina with exercise. Other children have no symptoms. Surgery may not alleviate chest pain. […] The surgical repair of pectus excavatum is a painful procedure. Length of stay in the hospital is determined primarily by pain control. […] Your child will be expected to get up out of bed and walk the day following surgery and will need to practice deep breathing to keep the lungs healthy and prevent pneumonia. […] Constipation is a common problem for children on narcotics. Laxatives will be started in the hospital and should be continued, as needed, at home after discharge.

• #49 Pectus excavatum – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/care-at-mayo-clinic/mac-20355491

  Pectus excavatum care at Mayo Clinic […] Patients can breathe better after having this corrected it also improves their self-esteem. […] And because we’ve added cryotherapy to our pain management program, we’ve gone from a four to five day hospital stay now to an overnight procedure so people can come in have their surgery and go home the next day. […] We use a minimally invasive cryoablation probe to freeze the intercostal nerves temporarily which results in patients having a very low or no opioid requirement after surgery. […] Ultimately our goal is to get them back home and getting them back to a happy healthy life. […] Specialists in cardiology, pulmonary medicine, thoracic surgery and rehabilitation medicine work together to develop the best treatment plan for you or your child.

• #50 Pectus Excavatum – MU Health Care

  https://www.muhealth.org/conditions-treatments/pediatrics/general-surgery/chest-wall-deformities/pectus-excavatum

  In less severe cases, we offer a nonsurgical treatment called the vacuum bell. This is essentially a large suction cup that creates a vacuum seal on your child’s chest wall and lifts the sternum, correcting pectus excavatum over time. […] Our team utilizes an innovative approach to post-operative pain relief using cryoablation. During this procedure, a probe is inserted into the chest using small incisions and temporarily freezes the nerves. Minimal numbness in the chest wall may last up to six months. […] When your child is awake in the recovery room, our nursing team and anesthesiologist work together to ensure he or she is as comfortable as possible. Your child will receive a combination of intravenous (IV) and oral pain medications, muscle relaxants and local anesthetic patches after surgery. We use minimal narcotic pain medications. […] Using these innovative approaches, the average hospital length of stay is usually 2-3 days.

• #51 pectus excavatum | Dayton Children’s Hospital

  https://www.childrensdayton.org/patients-visitors/services/pediatric-surgery/programs-and-services/chest-wall-malformations-center

  As a new approach to pain management, Dayton Children’s offers cryoablation for pectus excavatum patients. The process uses extreme cold to freeze nerves and prevent pain. Using this approach, patients will be virtually pain-free following surgery without the use of opioids or other traditional pain medications and decreases their inpatient stay at the hospital.

• #52 Pectus excavatum | Children’s Wisconsin

  https://childrenswi.org/medical-care/surgery/conditions/chest-wall-program/pectus-excavatum

  Pectus excavatum can be treated with one of the following procedures: […] The Nuss procedure does carry a very low risk of injury to the heart, bar movement, bar infection, and bar allergy. […] Recovery from a Nuss procedure occurs completely within 3 months. […] We have seen major improvements in recovery associated with our Multimodal Pain Management program, which uses many different classes of pain medications at the same time to make our patients more comfortable. […] The optimal time for correction is 13-14 years for most affected, and using this method becomes a significantly different recovery for those of adult stature, although we have completed adult Nuss procedures at our center. […] For the right patient and family, chest wall correction can be transformative. […] Recovery is often 3-5 days in hospital with 2 drains that are removed a few days after surgery.

• #53 Pectus Excavatum Symptoms and Treatment – CTVS Texas

  https://ctvstexas.com/pectus-excavatum-symptoms-and-treatment/

  Board-certified thoracic surgeon, Dr. Rachel Medbery, treats a condition known as pectus excavatum, a chest wall deformity that causes a person’s breastbone to sink inward. […] Severe cases of the disease can impact a patient’s heart and lung function, but even mild cases can make a person feel insecure about their appearance. […] Patients with pectus excavatum will complain of chest pain and shortness of breath, especially during exercise. […] Fortunately, surgery can correct the deformity, but Dr. Medbery warns that it is a complex one. […] For patients with shortness of breath and chest pain with exercise, she says repairing the chest wall can make a significant, positive impact. […] Dr. Medbery says most patients will recover in about three months and must take special care in protecting their chest wall, including not riding in the front seat of a car (an airbag deployment would undo the corrective surgery) and wearing a special brace. […] Pain control for pectus excavatum surgery includes: Anti-inflammatories, Muscle relaxers, Nerve blocks, Anti-anxiety medicine, Some narcotics.

• #54 Pectus Excavatum | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/pectus-excavatum

  Pectus excavatum repair is a painful procedure. The length of your child’s hospital stay will depend on the pain level experienced after the operation. Most children stay in the hospital for about five days after the operation if a traditional method of pain management is used. In the traditional method, an epidural catheter (placed in the back) is used to give continuous pain medication for several days, when pain is greatest. While the epidural is in place, your child will also have a urinary catheter in place. In addition, your child may be given oxygen with a small tube under the nose. If cryoanalgesia is used for pain control, most patients can go home one day after the operation and a urinary catheter isn’t needed. […] You can help speed your child’s recovery by encouraging deep breathing, walking and sitting in a chair as soon as possible after the operation.

• #55 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Post operatively your child will have a small tube that puts pain medicine into the spinal fluid (epidural catheter) for 2 3 days. Other medications will be given through the IV, then by mouth. These medications will help to prevent pain, constipation and anxiety and provide muscle relaxation. […] Postoperatively, your child will need to take deep breaths using a device called an incentive spirometer every hour while awake, and will be awakened every two hours during sleep. This is very important to prevent respiratory congestion or pneumonia. […] Positioning may be a challenge for your child. S/he will need to sleep flat on his/her back with only a small pillow under the head. No one should pull on your childs arms during repositioning. Slouching, rolling, side lying, rotation or bending must be avoided. Your child should not attempt to get out of bed or walk without assistance.

• #56 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  What kind of care is needed at home after surgery? Care of the incisions: Wash with mild soap and water only. No ointments or creams are needed. Activity limitations: Daily walking and breathing exercises are expected. Heavy lifting and use of back-packs must be avoided for three months. Diet: His/her normal diet. Increase fluids/fruits and vegetables to prevent constipation. Bathing: May shower. Medication: Ibuprofen should be given every 6 hours, around the clock, for several weeks. This will relieve pain and act as an anti-inflammatory medication. Zantac is ordered every 8 hours while your child is on Ibuprofen around the clock. This will protect the stomach from irritation. Narcotic analgesia (Percocet) should be no more often than every four to six hours after one week at home. Muscle relaxants (Valium, Robaxin) should be twice daily after the first few days at home.

• #57 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  After a Nuss procedure you will be hospitalized for 2 – 3 days. Immediate mobilization is important and the staff will help and support you. […] The nursing staff and the physiotherapist will help and instruct you regarding how best to move, bearing in mind your restrictions. […] During hospitalization the nurse will help you look after the dressing and if necessary change it. […] You will be talking to the staff about pain relief several times a day, so we can adapt it to your needs. […] You may have difficulty urinating on your own the first few times, and it may be necessary for us to help you use a disposable catheter the first couple of times, until you can urinate on your own again. […] Whilst you are receiving analgesics and are not moving about as normal you will need a laxative to keep your bowel moving.

• #58 Pectus Excavatum | Duke Health

  https://www.dukehealth.org/pediatric-treatments/pectus-excavatum

  Children diagnosed with or suspected of having pectus excavatum receive expert care from Duke pediatric surgeons and nurse practitioners who specialize in treating this chest wall deformity. […] Our providers are trained in testing, monitoring, and treating a sunken chest. We involve you in all decisions about your child’s care and carefully explain our recommendations. […] Recovery can be painful as bones adjust and settle. We will work with you and your child to keep them as comfortable as possible in the days after surgery and will monitor their progress as they heal. […] In the days following surgery, our physical and occupational therapy teams will begin work with your child to help them stand and move on their own comfortably. Additional therapy after your child leaves the hospital is optional. We make sure they regain a safe range of motion, so they can return to regular childhood activities as soon as possible.

• #59 Pectus excavatum repair Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/surgery/pectus-excavatum-repair

  It is common for children to stay in the hospital for 3 to 7 days. How long your child stays depends on how well the recovery is going. […] Pain is common after the surgery. For the first few days, your child may receive strong pain medicine in the vein (through an IV) or through a catheter placed in the spine (an epidural). After that, pain is usually managed with medicines taken by mouth. […] Your child may have tubes in the chest around the surgical cuts. These tubes drain extra fluid that collects from the procedure. The tubes will remain in place until they stop draining, usually after a few days. The tubes are then removed. […] The day after surgery, your child will be encouraged to sit up, take deep breaths, and get out of bed and walk. These activities will help healing. […] At home, follow any instructions for caring for your child.

• #60 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Pectus excavatum is a congenital disorder which causes the chest to have a sunken or „caved in” appearance. […] Some children with pectus excavatum report that they have chest pain and shortness of breath or limited stamina with exercise. Other children have no symptoms. Surgery may not alleviate chest pain. […] The surgical repair of pectus excavatum is a painful procedure. Length of stay in the hospital is determined primarily by pain control. […] Your child will be expected to get up out of bed and walk the day following surgery and will need to practice deep breathing to keep the lungs healthy and prevent pneumonia. […] Constipation is a common problem for children on narcotics. Laxatives will be started in the hospital and should be continued, as needed, at home after discharge.

• #61 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Post operatively your child will have a small tube that puts pain medicine into the spinal fluid (epidural catheter) for 2 3 days. Other medications will be given through the IV, then by mouth. These medications will help to prevent pain, constipation and anxiety and provide muscle relaxation. […] Postoperatively, your child will need to take deep breaths using a device called an incentive spirometer every hour while awake, and will be awakened every two hours during sleep. This is very important to prevent respiratory congestion or pneumonia. […] Positioning may be a challenge for your child. S/he will need to sleep flat on his/her back with only a small pillow under the head. No one should pull on your childs arms during repositioning. Slouching, rolling, side lying, rotation or bending must be avoided. Your child should not attempt to get out of bed or walk without assistance.

• #62 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Pectus excavatum is a congenital disorder which causes the chest to have a sunken or „caved in” appearance. […] Some children with pectus excavatum report that they have chest pain and shortness of breath or limited stamina with exercise. Other children have no symptoms. Surgery may not alleviate chest pain. […] The surgical repair of pectus excavatum is a painful procedure. Length of stay in the hospital is determined primarily by pain control. […] Your child will be expected to get up out of bed and walk the day following surgery and will need to practice deep breathing to keep the lungs healthy and prevent pneumonia. […] Constipation is a common problem for children on narcotics. Laxatives will be started in the hospital and should be continued, as needed, at home after discharge.

• #63 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  After a Nuss procedure you will be hospitalized for 2 – 3 days. Immediate mobilization is important and the staff will help and support you. […] The nursing staff and the physiotherapist will help and instruct you regarding how best to move, bearing in mind your restrictions. […] During hospitalization the nurse will help you look after the dressing and if necessary change it. […] You will be talking to the staff about pain relief several times a day, so we can adapt it to your needs. […] You may have difficulty urinating on your own the first few times, and it may be necessary for us to help you use a disposable catheter the first couple of times, until you can urinate on your own again. […] Whilst you are receiving analgesics and are not moving about as normal you will need a laxative to keep your bowel moving.

• #64 Nuss Procedure | Pectus Clinic

  https://www.pectusclinic.com/treatments/surgery/nuss-procedure/

  The immediate recovery time in the hospital is 3-5 days. Attention is paid to post operative pain relief and advice on how to move about to maintain the position of the bar. […] Increasingly the importance of physical therapy following surgery is recognised to both help the recovery and to improve on some of the typical issues around poor posture and muscle tone common in pectus excavatum patients. Often re-training the breathing muscles and encouraging deep breathing is also encouraged. […] Physical activity: Its important that the day following the surgery you begin to mobilise, and you will be encouraged to sit out of bed, start walking and begin physiotherapy exercises. It helps reduce risks of blood clot and chest infections. It helps your bowels begin to work and start to feel like eating again.

• #65 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  After a Nuss procedure you will be hospitalized for 2 – 3 days. Immediate mobilization is important and the staff will help and support you. […] The nursing staff and the physiotherapist will help and instruct you regarding how best to move, bearing in mind your restrictions. […] During hospitalization the nurse will help you look after the dressing and if necessary change it. […] You will be talking to the staff about pain relief several times a day, so we can adapt it to your needs. […] You may have difficulty urinating on your own the first few times, and it may be necessary for us to help you use a disposable catheter the first couple of times, until you can urinate on your own again. […] Whilst you are receiving analgesics and are not moving about as normal you will need a laxative to keep your bowel moving.

• #66 Pectus Excavatum | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] If you child is discharged with a drain in place, it will be removed in the surgical office when the draining had stopped. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #67 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #68 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  What kind of care is needed at home after surgery? Care of the incisions: Wash with mild soap and water only. No ointments or creams are needed. Activity limitations: Daily walking and breathing exercises are expected. Heavy lifting and use of back-packs must be avoided for three months. Diet: His/her normal diet. Increase fluids/fruits and vegetables to prevent constipation. Bathing: May shower. Medication: Ibuprofen should be given every 6 hours, around the clock, for several weeks. This will relieve pain and act as an anti-inflammatory medication. Zantac is ordered every 8 hours while your child is on Ibuprofen around the clock. This will protect the stomach from irritation. Narcotic analgesia (Percocet) should be no more often than every four to six hours after one week at home. Muscle relaxants (Valium, Robaxin) should be twice daily after the first few days at home.

• #69 Pectus excavatum repair Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/surgery/pectus-excavatum-repair

  It is common for children to stay in the hospital for 3 to 7 days. How long your child stays depends on how well the recovery is going. […] Pain is common after the surgery. For the first few days, your child may receive strong pain medicine in the vein (through an IV) or through a catheter placed in the spine (an epidural). After that, pain is usually managed with medicines taken by mouth. […] Your child may have tubes in the chest around the surgical cuts. These tubes drain extra fluid that collects from the procedure. The tubes will remain in place until they stop draining, usually after a few days. The tubes are then removed. […] The day after surgery, your child will be encouraged to sit up, take deep breaths, and get out of bed and walk. These activities will help healing. […] At home, follow any instructions for caring for your child.

• #70 Pectus Excavatum | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] If you child is discharged with a drain in place, it will be removed in the surgical office when the draining had stopped. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #71 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  After a Nuss procedure you will be hospitalized for 2 – 3 days. Immediate mobilization is important and the staff will help and support you. […] The nursing staff and the physiotherapist will help and instruct you regarding how best to move, bearing in mind your restrictions. […] During hospitalization the nurse will help you look after the dressing and if necessary change it. […] You will be talking to the staff about pain relief several times a day, so we can adapt it to your needs. […] You may have difficulty urinating on your own the first few times, and it may be necessary for us to help you use a disposable catheter the first couple of times, until you can urinate on your own again. […] Whilst you are receiving analgesics and are not moving about as normal you will need a laxative to keep your bowel moving.

• #72 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Post operatively your child will have a small tube that puts pain medicine into the spinal fluid (epidural catheter) for 2 3 days. Other medications will be given through the IV, then by mouth. These medications will help to prevent pain, constipation and anxiety and provide muscle relaxation. […] Postoperatively, your child will need to take deep breaths using a device called an incentive spirometer every hour while awake, and will be awakened every two hours during sleep. This is very important to prevent respiratory congestion or pneumonia. […] Positioning may be a challenge for your child. S/he will need to sleep flat on his/her back with only a small pillow under the head. No one should pull on your childs arms during repositioning. Slouching, rolling, side lying, rotation or bending must be avoided. Your child should not attempt to get out of bed or walk without assistance.

• #73 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Pectus excavatum is a congenital disorder which causes the chest to have a sunken or „caved in” appearance. […] Some children with pectus excavatum report that they have chest pain and shortness of breath or limited stamina with exercise. Other children have no symptoms. Surgery may not alleviate chest pain. […] The surgical repair of pectus excavatum is a painful procedure. Length of stay in the hospital is determined primarily by pain control. […] Your child will be expected to get up out of bed and walk the day following surgery and will need to practice deep breathing to keep the lungs healthy and prevent pneumonia. […] Constipation is a common problem for children on narcotics. Laxatives will be started in the hospital and should be continued, as needed, at home after discharge.

• #74 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  You will be given antibiotics during hospitalisation to reduce the risk of inflammation. […] The discharge will be planned as a collaboration between you, your relative, the physiotherapist, the nurse and the surgeon who operated on you. […] Before you are discharged you must discuss with the physiotherapist where the subsequent exercises are to take place and what they will comprise. […] You and, where applicable, the relative(s) who will be helping you at home will talk to the nurse about analgesics, the wound, the dressing, bowel function and follow-up of developments before you go home.

• #75 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  After a Nuss procedure you will be hospitalized for 2 – 3 days. Immediate mobilization is important and the staff will help and support you. […] The nursing staff and the physiotherapist will help and instruct you regarding how best to move, bearing in mind your restrictions. […] During hospitalization the nurse will help you look after the dressing and if necessary change it. […] You will be talking to the staff about pain relief several times a day, so we can adapt it to your needs. […] You may have difficulty urinating on your own the first few times, and it may be necessary for us to help you use a disposable catheter the first couple of times, until you can urinate on your own again. […] Whilst you are receiving analgesics and are not moving about as normal you will need a laxative to keep your bowel moving.

• #76 Nuss Procedure | Pectus Clinic

  https://www.pectusclinic.com/treatments/surgery/nuss-procedure/

  Pain control: You will have a chance to discuss pain control before the surgery with the anaesthetist. The spinal injection if given before the operation helps pain control in the first and second day after surgery but begins to wear off. […] You will be in hospital typically 3 days. A drain/s may be put in at the time of the operation to drain any blood or air that collects after the surgery. This will be removed. Antibiotics will be administrated to reduce the risk of infection and treatment to prevent blood clots (TED stockings and blood thinning medications) until you are walking. […] Following discharge, you will be given advice about what to expect in the coming days and weeks after the surgery. […] Its quite common in the few weeks following surgery to feel off your food, feel tired and have changes in your bowel habit (constipation). Many patients report losing weight following the surgery. Its important that your recover well after the operation, so eating well, regular activity (walking) and a return to normal daily activities (not exercise) is encouraged in the first 4 weeks after surgery.

• #77 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  You will be given antibiotics during hospitalisation to reduce the risk of inflammation. […] The discharge will be planned as a collaboration between you, your relative, the physiotherapist, the nurse and the surgeon who operated on you. […] Before you are discharged you must discuss with the physiotherapist where the subsequent exercises are to take place and what they will comprise. […] You and, where applicable, the relative(s) who will be helping you at home will talk to the nurse about analgesics, the wound, the dressing, bowel function and follow-up of developments before you go home.

• #78 Pectus Excavatum | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pectus-excavatum

  After being discharged from the hospital, your child will follow up in the general surgery clinic in 2-4 weeks. Your child’s surgeon or nurse practitioner will go over pain management and activity restrictions, and any other information you may need to care for your child at home. […] While it is not mandatory to wear a Medical Alert bracelet after surgical correction of pectus excavatum, it is strongly recommended. Information can be provided to you at a post-operative visit on obtaining a Medical Alert bracelet. The inscription on the bracelet should read steel bar in chest, CPR more force, cardioversion ant/post placement.

• #79 Pectus Excavatum | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] If you child is discharged with a drain in place, it will be removed in the surgical office when the draining had stopped. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #80 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #81 Pectus Excavatum | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] If you child is discharged with a drain in place, it will be removed in the surgical office when the draining had stopped. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #82 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #83 Pectus Excavatum | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] If you child is discharged with a drain in place, it will be removed in the surgical office when the draining had stopped. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #84 Care after Nuss procedure | Aleris

  https://www.aleris.dk/en/hospital-services/pectus-excavatum/faq/care-after-nuss-procedure/

  You will be given antibiotics during hospitalisation to reduce the risk of inflammation. […] The discharge will be planned as a collaboration between you, your relative, the physiotherapist, the nurse and the surgeon who operated on you. […] Before you are discharged you must discuss with the physiotherapist where the subsequent exercises are to take place and what they will comprise. […] You and, where applicable, the relative(s) who will be helping you at home will talk to the nurse about analgesics, the wound, the dressing, bowel function and follow-up of developments before you go home.

• #85 Pectus Excavatum | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/pectus-excavatum

  After bringing your child home, please keep the following in mind: […] Pain When your child leaves the hospital, you will be given a prescription for pain medication. […] Activity Your child may resume regular activities as tolerated. […] Bathing Your child may shower after two days. Baths are allowed after a week. […] Dressings Gauze and clear plastic dressings placed over the incisions may be removed a few days after surgery. Over the incision, there will be small strips of white adhesive tape. It’s normal to see a small amount of blood on the strips. The skin surrounding the incision may be red and bruised. Eventually, the tape will loosen and fall off. […] Swelling There may be slight swelling at the incision site. After the incision heals, you’ll feel a firm ridge, called a „healing ridge,” under the incision. This is where the tissues were sewn together. It may be present for several months.

• #86 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  What kind of care is needed at home after surgery? Care of the incisions: Wash with mild soap and water only. No ointments or creams are needed. Activity limitations: Daily walking and breathing exercises are expected. Heavy lifting and use of back-packs must be avoided for three months. Diet: His/her normal diet. Increase fluids/fruits and vegetables to prevent constipation. Bathing: May shower. Medication: Ibuprofen should be given every 6 hours, around the clock, for several weeks. This will relieve pain and act as an anti-inflammatory medication. Zantac is ordered every 8 hours while your child is on Ibuprofen around the clock. This will protect the stomach from irritation. Narcotic analgesia (Percocet) should be no more often than every four to six hours after one week at home. Muscle relaxants (Valium, Robaxin) should be twice daily after the first few days at home.

• #87 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  What kind of care is needed at home after surgery? Care of the incisions: Wash with mild soap and water only. No ointments or creams are needed. Activity limitations: Daily walking and breathing exercises are expected. Heavy lifting and use of back-packs must be avoided for three months. Diet: His/her normal diet. Increase fluids/fruits and vegetables to prevent constipation. Bathing: May shower. Medication: Ibuprofen should be given every 6 hours, around the clock, for several weeks. This will relieve pain and act as an anti-inflammatory medication. Zantac is ordered every 8 hours while your child is on Ibuprofen around the clock. This will protect the stomach from irritation. Narcotic analgesia (Percocet) should be no more often than every four to six hours after one week at home. Muscle relaxants (Valium, Robaxin) should be twice daily after the first few days at home.

• #88 Pectus Excavatum | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/pectus-excavatum

  After bringing your child home, please keep the following in mind: […] Pain When your child leaves the hospital, you will be given a prescription for pain medication. […] Activity Your child may resume regular activities as tolerated. […] Bathing Your child may shower after two days. Baths are allowed after a week. […] Dressings Gauze and clear plastic dressings placed over the incisions may be removed a few days after surgery. Over the incision, there will be small strips of white adhesive tape. It’s normal to see a small amount of blood on the strips. The skin surrounding the incision may be red and bruised. Eventually, the tape will loosen and fall off. […] Swelling There may be slight swelling at the incision site. After the incision heals, you’ll feel a firm ridge, called a „healing ridge,” under the incision. This is where the tissues were sewn together. It may be present for several months.

• #89 Pre and post operative care in the new surgical treatment of the Pectus Excavatum: Pectus Up – Pectus Up

  https://pectusup.com/en/pre-post-operative-care-pectus-up/

  Preparation for surgery with Pectus Up […] Postoperative care and supervision are important when the patient has undergone surgical treatment of Pectus Excavatum. […] Care should be taken with personal hygiene to avoid possible infections. […] The wound may not be touched or wet. In addition, the dressing should not be lifted until the first check-up by the surgeon. […] It is advisable to sleep on your back and avoid being on your side during sleep (at least during the first 3 months). […] You must maintain a good trunk position and avoid exposing yourself to risky situations. […] Absolute rest for about a week after the intervention. […] Activities which might be performed will always depend on the evolution of each patient and the recommendations of the surgeon. […] Perform gentle breathing exercises on a daily basis during the first fifteen days of the intervention, such as gently inspiring until the chest is completely filled; then exhale slowly until the lung is empty of air.

• #90 Nuss Procedure | Pectus Clinic

  https://www.pectusclinic.com/treatments/surgery/nuss-procedure/

  To avoid excessive pain and to reduce the risk of the bar/s used to correct your pectus from moving or becoming dislodged. This includes: Sleeping on your back and avoiding sleeping on your side, Avoid sudden and excessive bending or twisting your upper body, Avoid lifting / carrying heavy weights that require you to strain, Walking and deep breathing exercises are encouraged. […] After 12 weeks: You are able to return to all physical activity and sports however, if you participate in potentially violent contact sports such as rugby or martial arts some caution is required, and further advice can be offered if these sports are important to you.

• #91 What to Expect & FAQs Pectus Excavatum (in adults) | WakeMed

  https://www.wakemed.org/wakemed-physician-practices/specialties/pediatric-surgery/chest-wall-deformity-center/chest-wall-conditions-and-treatments/pectus-excavatum/what-to-expect-faqs-pectus-excavatum-in-adults

  You may be in the hospital for three to five days following surgery. Some patients are discharged sooner, and others may need to stay longer. During the hospital stay, you will: […] Walk with the assistance of a physical therapist or nurse who will teach you how to move with the bar (or bars) in place. Walking will help increase strength and encourage deep breathing. […] Most patients feel better after a week at home; however, caution must be taken when advancing movement, etc. Activities will be restricted for several weeks to ensure that the bar is secure in place. […] We encourage patients to be active. Patients can return to vigorous physical activity approximately two months after surgery. Remember that the bars are in place for two to three years and there may be at least some sensation of chest wall restriction (especially with vigorous breathing) while the bars are in place. This typically resolves once the hardware (bars) are removed.

• #92 Pre and post operative care in the new surgical treatment of the Pectus Excavatum: Pectus Up – Pectus Up

  https://pectusup.com/en/pre-post-operative-care-pectus-up/

  Preparation for surgery with Pectus Up […] Postoperative care and supervision are important when the patient has undergone surgical treatment of Pectus Excavatum. […] Care should be taken with personal hygiene to avoid possible infections. […] The wound may not be touched or wet. In addition, the dressing should not be lifted until the first check-up by the surgeon. […] It is advisable to sleep on your back and avoid being on your side during sleep (at least during the first 3 months). […] You must maintain a good trunk position and avoid exposing yourself to risky situations. […] Absolute rest for about a week after the intervention. […] Activities which might be performed will always depend on the evolution of each patient and the recommendations of the surgeon. […] Perform gentle breathing exercises on a daily basis during the first fifteen days of the intervention, such as gently inspiring until the chest is completely filled; then exhale slowly until the lung is empty of air.

• #93 Pectus excavatum from a pediatric surgeon’s perspective – Nuss- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/11847/html

  Our recommendation is to offer pectus excavatum repair provided the patient fulfills two or more of the following criteria: […] The post-operative management protocols are similar for children as for older patients. Since children tend to be more anxious and less tolerant of pain, it is important to allay their anxiety before and after surgery and to pre-empt the pain cascade by being very pro-active with pain management and sedation, especially during emergence from anesthesia and during the first 48 hours after repair. […] When patients start to feel better, it is important to remind them to refrain from sports activities, to avoid heavy lifting, and sleep on their back for a minimum of 6 weeks. After 6 weeks, they may slowly resume normal activities, and by 3 months they may resume competitive sports except for those that run the risk of significant chest wall trauma (e.g., boxing, American football, rugby, hockey, kick boxing) They should continue with deep breathing exercises twice a day until the bar has been removed and to participate in aerobic sports activities.

• #94 Pectus Excavatum | Children’s Mercy Kansas City

  https://www.childrensmercy.org/departments-and-clinics/center-for-pectus-excavatum-and-carinatum/pectus-excavatum/

  Encourage your child to live an active lifestyle without any restrictions, unless your care team recommends otherwise. People who have pectus excavatum can continue to participate in all activities they find enjoyable. […] Your child will go home with short-term oral pain medications to continue during their recovery. Most children can go home the day of surgery. […] Follow these guidelines to help your child recover and gradually return to normal activities after surgery: No strenuous physical activity for 2 weeks following surgery. […] Your child can return to school when their energy level improves and pain is well-controlled. […] If you have a question, you can send a message to the Pectus Center through the patient portal or call the Surgery Clinic at (816) 234-3097. Please contact us if your child is experiencing any of the following concerns: The incision becomes red, swollen, very painful or begins draining or a rash develops.

• #95 Pectus Excavatum vs. Pectus Carinatum

  https://www.cookchildrens.org/services/pediatric-surgery/specialty-programs/pectus-excavatum-carinatum/

  Children are typically able to return to school two-three weeks after surgical repair. […] When to call the doctor: Coughing that won’t stop. Increased pain. Fever greater than 100.5 F. Respiratory distress (difficulty breathing). Any signs of infection from the incision site (redness, swelling, and/or pus like drainage).

• #96 Pectus Excavatum | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/pectus-excavatum

  If all goes well, your child will have a scheduled follow-up visit with us between two and four weeks after leaving the hospital. […] If you have any concerns once your child is home, please call the Pediatric Surgery Clinic at (415) 476-2538 (San Francisco clinic) or (510) 428-3022 (Oakland clinic). You should also call if your child develops any of the following: […] A temperature of 101.5 F or higher […] A red incision […] Worsening pain and tenderness at the incision […] Fluid coming from the incision.

• #97 Pectus Excavatum | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/pectus-excavatum

  If all goes well, your child will have a scheduled follow-up visit with us between two and four weeks after leaving the hospital. […] If you have any concerns once your child is home, please call the Pediatric Surgery Clinic at (415) 476-2538 (San Francisco clinic) or (510) 428-3022 (Oakland clinic). You should also call if your child develops any of the following: […] A temperature of 101.5 F or higher […] A red incision […] Worsening pain and tenderness at the incision […] Fluid coming from the incision.

• #98 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #99 Pectus Excavatum vs. Pectus Carinatum

  https://www.cookchildrens.org/services/pediatric-surgery/specialty-programs/pectus-excavatum-carinatum/

  Children are typically able to return to school two-three weeks after surgical repair. […] When to call the doctor: Coughing that won’t stop. Increased pain. Fever greater than 100.5 F. Respiratory distress (difficulty breathing). Any signs of infection from the incision site (redness, swelling, and/or pus like drainage).

• #100 Pectus Excavatum vs. Pectus Carinatum

  https://www.cookchildrens.org/services/pediatric-surgery/specialty-programs/pectus-excavatum-carinatum/

  Children are typically able to return to school two-three weeks after surgical repair. […] When to call the doctor: Coughing that won’t stop. Increased pain. Fever greater than 100.5 F. Respiratory distress (difficulty breathing). Any signs of infection from the incision site (redness, swelling, and/or pus like drainage).

• #101 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Are there limitations on sports activities? Yes. No sports until cleared by the surgeon. Usually, aerobic training can start in two months. Competing in non-contact sports can start after three months but football, hockey, kick boxing, soccer and rugby are not recommended at all. […] What are the long-term consequences? The bar will stay in place for 2 4 years. After removal, continuing an exercise program is important. A certified physical therapist can help with proper, safe training. During that time, any trauma to the chest should be reported to the surgeon immediately. If CPR is needed, increased force must be used. […] In rare cases, pectus excavatum can recur. […] Is there anything else I need to know to care for my child? Follow up with pulmonary function testing will occur at six months post operatively. Your child should order and wear a Medic Alert bracelet to signify that s/he has a pectus bar in place. This company can be reached by calling: 1888-633-4298 or on line: www.medicalert.org. Your child may go through metal detectors but will likely set off the alarm. You should carry written documentation about the bar along with the Medic Alert bracelet to avoid problems. MRIs may be done after three months, but the scan may not be as clear as necessary due to the bar.

• #102 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #103 Pectus excavatum from a pediatric surgeon’s perspective – Nuss- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/11847/html

  The bar should remain in place for 2 to 4 years, but taking into consideration the severity of the chest wall deformity and the age of the patient at the time of removal for optimal timing. […] Ideally, the bar should remain in place for 3 years as there are no recurrences recorded after 36 months. […] While the incidence of congenital pectus excavatum and heritability has not been established yet, what is currently known is that the deformity tends to become more severe as the child grows and the progression is especially significant during the pubertal growth spurt. Close observation during this time period allows the patient and family to be presented with various treatment strategies. All patients are started on an exercise and posture program in order to improve their posture and expand their chest, regardless of whether they are being treated operatively or non-operatively. Vacuum bell therapy may be beneficial for a subset of patients. If the deformity is severe, as judged by specific clinical and objective criteria, then those patients should be offered MIRPE. The procedure is the same for children and adults. Postoperative protocols in the hospital and at home are very important in order to reduce the risk of complications and to improve results. The outcomes are reported as good or excellent by both patients and surgeons in over 98% of the cases, while less than 2% report results as poor, fair, or failed. MIRPE is also associated with high patient satisfaction (i.e., Very Happy or Happy) in over 95% of cases.

• #104 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Young patients may also be referred for vacuum bell therapy as a bridge to potential surgical correction or definitive therapy, as described later. […] Though MIRPE is considered the gold standard treatment for pectus excavatum, there is a need for less invasive treatment modalities that are effective in defect correction and pain management. […] The ideal vacuum bell candidate is relatively young with a flexible chest wall, has a mild to moderate chest wall deformity, and is motivated to be compliant with therapy. […] Pain control following surgical repair of pectus excavatum is often challenging and is a significant contributor to length of stay (LOS). […] Recent advances in protocolized pain management and multimodal pain control have significantly reduced postoperative LOS and narcotic usage after MIRPE. […] Regardless of technique, pediatric patients should be followed postoperatively until they reach full stature to ensure a satisfactory result without unwanted secondary effects of the pectus bar including secondary pectus carinatum or increased costal flaring.

• #105 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #106 Pectus Excavatum – Chest Wall Reconstruction | Pediatric Surgery | University Hospitals | University Hospitals

  https://www.uhhospitals.org/rainbow/services/pediatric-surgery/conditions-and-treatments/pediatric-chest-wall-reconstruction/pectus-excavatum

  Pectus excavatum, also known as funnel chest or sunken chest, is a fairly common chest wall deformity that causes some of the ribs to grow inwards, giving the chest a caved-in appearance. […] Though most cases do not require surgery, surgical correction of severe pectus excavatum can provide both functional and cosmetic improvements. […] Most mild cases of pectus excavatum will not require surgery. If symptoms are bothersome, physical therapy and exercises can be helpful. […] Your child can return to school and light activity around three weeks after surgery. For about six weeks, he or she should avoid activities that involve twisting of the torso, including driving. Patients are advised to restrict heavier activities for about nine months to a year. Your child will have a follow-up visit with their surgeon three weeks after surgery, and will have periodic check-ups for the next couple of years to monitor their progress and determine when the bar should be removed usually about three years after the surgery.

• #107 Pectus Excavatum | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/pectus-excavatum

  If all goes well, your child will have a scheduled follow-up visit with us between two and four weeks after leaving the hospital. […] If you have any concerns once your child is home, please call the Pediatric Surgery Clinic at (415) 476-2538 (San Francisco clinic) or (510) 428-3022 (Oakland clinic). You should also call if your child develops any of the following: […] A temperature of 101.5 F or higher […] A red incision […] Worsening pain and tenderness at the incision […] Fluid coming from the incision.

• #108 Pectus Excavatum | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pectus-excavatum

  After being discharged from the hospital, your child will follow up in the general surgery clinic in 2-4 weeks. Your child’s surgeon or nurse practitioner will go over pain management and activity restrictions, and any other information you may need to care for your child at home. […] While it is not mandatory to wear a Medical Alert bracelet after surgical correction of pectus excavatum, it is strongly recommended. Information can be provided to you at a post-operative visit on obtaining a Medical Alert bracelet. The inscription on the bracelet should read steel bar in chest, CPR more force, cardioversion ant/post placement.

• #109 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #110 Pectus Excavatum | Sunken Chest Surgery | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/pectus-excavatum/

  Pectus excavatum, also known as sunken chest or funnel chest, is the most frequent congenital anomaly of the chest wall, occurring in 1 in 400 births, and is found in 2.6 percent of children aged 714. […] Funnel chest may cause children to sometimes feel shortness of breath or experience exercise intolerance or palpitations, interfering with heart and lung function. […] Although the initial care may include monitoring a patients growth and chest-specific physical therapy, surgical correction may be provided. […] If your child is an appropriate candidate for surgery, it is likely they will have either the Ravitch procedure or the minimally invasive Nuss procedure. […] It is important to take very good care of the surgical site until it is fully healed. […] In terms of resuming normal activity, patients are generally advised to abstain from heavy physical exertion for about 6 weeks. […] Routine post-surgical follow-up with your pediatric surgeon and team is important and should be done at regular intervals for up to two years post-surgery.

• #111 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Young patients may also be referred for vacuum bell therapy as a bridge to potential surgical correction or definitive therapy, as described later. […] Though MIRPE is considered the gold standard treatment for pectus excavatum, there is a need for less invasive treatment modalities that are effective in defect correction and pain management. […] The ideal vacuum bell candidate is relatively young with a flexible chest wall, has a mild to moderate chest wall deformity, and is motivated to be compliant with therapy. […] Pain control following surgical repair of pectus excavatum is often challenging and is a significant contributor to length of stay (LOS). […] Recent advances in protocolized pain management and multimodal pain control have significantly reduced postoperative LOS and narcotic usage after MIRPE. […] Regardless of technique, pediatric patients should be followed postoperatively until they reach full stature to ensure a satisfactory result without unwanted secondary effects of the pectus bar including secondary pectus carinatum or increased costal flaring.

• #112 NUSS Procedure | Pectus Excavatum Surgery | CHOC – Sunken Chest Surgery, Recovery & Survival Rates

  https://choc.org/programs-services/pediatric-general-surgery/pectus-excavatum-sunken-chest-nuss/

  The pectus excavatum team at CHOC is comprised of experts in pediatric pulmonology, cardiology and surgery. The multidisciplinary team performs various tests to examine heart and lung function, before and after surgery. By using the latest techniques in minimally invasive surgery, along with recent improvements in pain management, patients are able to return home and get back to their daily activities sooner than ever before. […] Our CHOC pectus surgeons have been doing the Nuss procedure since 2001 with a very high patient satisfaction and success rate. The pediatric surgeons at CHOC have done more than 300 successful Nuss procedures.

• #113 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Young patients may also be referred for vacuum bell therapy as a bridge to potential surgical correction or definitive therapy, as described later. […] Though MIRPE is considered the gold standard treatment for pectus excavatum, there is a need for less invasive treatment modalities that are effective in defect correction and pain management. […] The ideal vacuum bell candidate is relatively young with a flexible chest wall, has a mild to moderate chest wall deformity, and is motivated to be compliant with therapy. […] Pain control following surgical repair of pectus excavatum is often challenging and is a significant contributor to length of stay (LOS). […] Recent advances in protocolized pain management and multimodal pain control have significantly reduced postoperative LOS and narcotic usage after MIRPE. […] Regardless of technique, pediatric patients should be followed postoperatively until they reach full stature to ensure a satisfactory result without unwanted secondary effects of the pectus bar including secondary pectus carinatum or increased costal flaring.

• #114 Pre and post operative care in the new surgical treatment of the Pectus Excavatum: Pectus Up – Pectus Up

  https://pectusup.com/en/pre-post-operative-care-pectus-up/

  Relative rest during the first month. This will consist of gradually resuming activities of daily living, maintaining good trunk posture, avoiding movements that cause pain. […] Avoid twisting your torso and lifting weights during this first month. […] Refrain from sports that involve extensive movement of the torso such as golf, swimming (basically backstroke and breaststroke), tennis, lifting weights such as bench presses, etc. ., for a period of six months. […] Avoid all high-risk and contact sports. Contact sports are not recommended for at least the first six months after implantation. Severe trauma to the anterior chest can cause serious intrathoracic injury. […] Failure to follow postoperative instructions may result in adverse effects.

• #115 Nuss Procedure | Pectus Clinic

  https://www.pectusclinic.com/treatments/surgery/nuss-procedure/

  To avoid excessive pain and to reduce the risk of the bar/s used to correct your pectus from moving or becoming dislodged. This includes: Sleeping on your back and avoiding sleeping on your side, Avoid sudden and excessive bending or twisting your upper body, Avoid lifting / carrying heavy weights that require you to strain, Walking and deep breathing exercises are encouraged. […] After 12 weeks: You are able to return to all physical activity and sports however, if you participate in potentially violent contact sports such as rugby or martial arts some caution is required, and further advice can be offered if these sports are important to you.

• #116 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Constipation is a common problem when narcotic medications are used on a frequent basis. Milk of Magnesia or Colace can be given to prevent hard stools that will be difficult to pass. […] What should I call the surgery team for? Any increased chest pain, difficulty breathing, fever, redness or swelling at the incision sites, accidental trauma to the chest, or any problems or concerns. […] When can my child return to school? Your child can return to school in four weeks Narcotic medications should be completely discontinued before return to school. No back packs for 3 months. Ask for a second set of books for home! Possibly leave the classroom 5 minutes before the bell rings to avoid jostling in the hallways. […] Will I need a note to excuse him/her from PE? Yes. No strenuous activity in gym is permitted for three months. Light activity can occur after 6 weeks.

• #117 Nuss Procedure | Children’s Hospital Colorado

  https://www.childrenscolorado.org/doctors-and-departments/departments/pediatric-surgery/tests-procedures-services/nuss-procedure/

  The Nuss procedure is used to treat children with pectus excavatum, or funnel chest. The purpose of the procedure is to realign a depressed sternum and support it with a specially designed metal bar. The Nuss procedure provides the psychological advantage of improving a child’s self-esteem as well as improved cardiopulmonary function, which means they are able to breathe better and they have improved blood circulation through the heart. […] General recovery time for the procedure is a hospital stay of 2 to 5 days. Your child’s doctor will prescribe medication for the pain following the procedure and may also follow up with physical therapy in the weeks or months following the procedure. Most children return to school in a few weeks and resume normal activity about one month after the operation.

• #118 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Constipation is a common problem when narcotic medications are used on a frequent basis. Milk of Magnesia or Colace can be given to prevent hard stools that will be difficult to pass. […] What should I call the surgery team for? Any increased chest pain, difficulty breathing, fever, redness or swelling at the incision sites, accidental trauma to the chest, or any problems or concerns. […] When can my child return to school? Your child can return to school in four weeks Narcotic medications should be completely discontinued before return to school. No back packs for 3 months. Ask for a second set of books for home! Possibly leave the classroom 5 minutes before the bell rings to avoid jostling in the hallways. […] Will I need a note to excuse him/her from PE? Yes. No strenuous activity in gym is permitted for three months. Light activity can occur after 6 weeks.

• #119 Pectus and Chest Wall Deformities | CHRISTUS Health

  https://www.christushealth.org/get-care/services-specialties/pediatric-care/general-surgery/chest-wall-deformity

  A sunken chest, or pectus excavatum, is a deformity when the breastbone and rib cage sink into the chest, creating a caved-in chest wall deformity. […] The Nuss procedure is a minimally invasive operation. The surgeon inserts one or more curved metal bars under the chest wall. These bars are placed behind the breastbone and push the sunken chest outward, creating a more normal chest shape. The bars are usually left in place for several years to maintain the new shape of the chest as it heals and stabilizes. The operation is known for its high success rate and low risk of complications, including bleeding, infection, bar migration, and cardiac puncture. Patients who undergo this procedure report high levels of satisfaction. […] Surgery to correct the shape of the chest wall can be painful. Fortunately, researchers have made advances in controlling pain. Enhanced Recovery After Surgery (ERAS) protocols help our patients experience less pain, recover more quickly, and return home faster. After surgery, your child cannot participate in sporting events, weightlifting, aerobic exercise, or physical education for at least six weeks. These limitations allow your child’s bars to stabilize in the chest. After six weeks, your surgeon will go through a patient-specific plan for your gradual return to your regular activities. Most patients can return to contact sports three months after surgery.

• #120 Pectus excavatum from a pediatric surgeon’s perspective – Nuss- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/11847/html

  Our recommendation is to offer pectus excavatum repair provided the patient fulfills two or more of the following criteria: […] The post-operative management protocols are similar for children as for older patients. Since children tend to be more anxious and less tolerant of pain, it is important to allay their anxiety before and after surgery and to pre-empt the pain cascade by being very pro-active with pain management and sedation, especially during emergence from anesthesia and during the first 48 hours after repair. […] When patients start to feel better, it is important to remind them to refrain from sports activities, to avoid heavy lifting, and sleep on their back for a minimum of 6 weeks. After 6 weeks, they may slowly resume normal activities, and by 3 months they may resume competitive sports except for those that run the risk of significant chest wall trauma (e.g., boxing, American football, rugby, hockey, kick boxing) They should continue with deep breathing exercises twice a day until the bar has been removed and to participate in aerobic sports activities.

• #121 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #122 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Are there limitations on sports activities? Yes. No sports until cleared by the surgeon. Usually, aerobic training can start in two months. Competing in non-contact sports can start after three months but football, hockey, kick boxing, soccer and rugby are not recommended at all. […] What are the long-term consequences? The bar will stay in place for 2 4 years. After removal, continuing an exercise program is important. A certified physical therapist can help with proper, safe training. During that time, any trauma to the chest should be reported to the surgeon immediately. If CPR is needed, increased force must be used. […] In rare cases, pectus excavatum can recur. […] Is there anything else I need to know to care for my child? Follow up with pulmonary function testing will occur at six months post operatively. Your child should order and wear a Medic Alert bracelet to signify that s/he has a pectus bar in place. This company can be reached by calling: 1888-633-4298 or on line: www.medicalert.org. Your child may go through metal detectors but will likely set off the alarm. You should carry written documentation about the bar along with the Medic Alert bracelet to avoid problems. MRIs may be done after three months, but the scan may not be as clear as necessary due to the bar.

• #123 Pectus excavatum from a pediatric surgeon’s perspective – Nuss- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/11847/html

  The bar should remain in place for 2 to 4 years, but taking into consideration the severity of the chest wall deformity and the age of the patient at the time of removal for optimal timing. […] Ideally, the bar should remain in place for 3 years as there are no recurrences recorded after 36 months. […] While the incidence of congenital pectus excavatum and heritability has not been established yet, what is currently known is that the deformity tends to become more severe as the child grows and the progression is especially significant during the pubertal growth spurt. Close observation during this time period allows the patient and family to be presented with various treatment strategies. All patients are started on an exercise and posture program in order to improve their posture and expand their chest, regardless of whether they are being treated operatively or non-operatively. Vacuum bell therapy may be beneficial for a subset of patients. If the deformity is severe, as judged by specific clinical and objective criteria, then those patients should be offered MIRPE. The procedure is the same for children and adults. Postoperative protocols in the hospital and at home are very important in order to reduce the risk of complications and to improve results. The outcomes are reported as good or excellent by both patients and surgeons in over 98% of the cases, while less than 2% report results as poor, fair, or failed. MIRPE is also associated with high patient satisfaction (i.e., Very Happy or Happy) in over 95% of cases.

• #124 Pectus Excavatum – Chest Wall – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/services/chest-wall/pectus-excavatum.html

  Pectus excavatum may become more severe or apparent during periods of rapid growth. […] Early evaluation by a pediatric surgeon during the prepubertal period is helpful for families to gain an understanding of what to expect as their child matures and when intervention is optimal. […] We are pleased to offer this uncommon yet effective nonsurgical treatment option for mild to moderate pectus excavatum. […] The vacuum bell must be applied at regular intervals, eventually up to two hours each session, twice daily. […] Managing your child’s pain is very important to us. […] That’s why we offer state-of-the-art pain control techniques, including cryoablation and others to reduce pain and recovery time after surgery. […] The bar is generally removed between two to four years after the procedure and can be completed on an outpatient basis under general anesthesia.

• #125 Pectus excavatum from a pediatric surgeon’s perspective – Nuss- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/11847/html

  The bar should remain in place for 2 to 4 years, but taking into consideration the severity of the chest wall deformity and the age of the patient at the time of removal for optimal timing. […] Ideally, the bar should remain in place for 3 years as there are no recurrences recorded after 36 months. […] While the incidence of congenital pectus excavatum and heritability has not been established yet, what is currently known is that the deformity tends to become more severe as the child grows and the progression is especially significant during the pubertal growth spurt. Close observation during this time period allows the patient and family to be presented with various treatment strategies. All patients are started on an exercise and posture program in order to improve their posture and expand their chest, regardless of whether they are being treated operatively or non-operatively. Vacuum bell therapy may be beneficial for a subset of patients. If the deformity is severe, as judged by specific clinical and objective criteria, then those patients should be offered MIRPE. The procedure is the same for children and adults. Postoperative protocols in the hospital and at home are very important in order to reduce the risk of complications and to improve results. The outcomes are reported as good or excellent by both patients and surgeons in over 98% of the cases, while less than 2% report results as poor, fair, or failed. MIRPE is also associated with high patient satisfaction (i.e., Very Happy or Happy) in over 95% of cases.

• #126 Pectus Excavatum – Chest Wall – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/services/chest-wall/pectus-excavatum.html

  Pectus excavatum may become more severe or apparent during periods of rapid growth. […] Early evaluation by a pediatric surgeon during the prepubertal period is helpful for families to gain an understanding of what to expect as their child matures and when intervention is optimal. […] We are pleased to offer this uncommon yet effective nonsurgical treatment option for mild to moderate pectus excavatum. […] The vacuum bell must be applied at regular intervals, eventually up to two hours each session, twice daily. […] Managing your child’s pain is very important to us. […] That’s why we offer state-of-the-art pain control techniques, including cryoablation and others to reduce pain and recovery time after surgery. […] The bar is generally removed between two to four years after the procedure and can be completed on an outpatient basis under general anesthesia.

• #127 Pectus Excavatum – Chest Wall – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/services/chest-wall/pectus-excavatum.html

  Pectus excavatum may become more severe or apparent during periods of rapid growth. […] Early evaluation by a pediatric surgeon during the prepubertal period is helpful for families to gain an understanding of what to expect as their child matures and when intervention is optimal. […] We are pleased to offer this uncommon yet effective nonsurgical treatment option for mild to moderate pectus excavatum. […] The vacuum bell must be applied at regular intervals, eventually up to two hours each session, twice daily. […] Managing your child’s pain is very important to us. […] That’s why we offer state-of-the-art pain control techniques, including cryoablation and others to reduce pain and recovery time after surgery. […] The bar is generally removed between two to four years after the procedure and can be completed on an outpatient basis under general anesthesia.

• #128 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Are there limitations on sports activities? Yes. No sports until cleared by the surgeon. Usually, aerobic training can start in two months. Competing in non-contact sports can start after three months but football, hockey, kick boxing, soccer and rugby are not recommended at all. […] What are the long-term consequences? The bar will stay in place for 2 4 years. After removal, continuing an exercise program is important. A certified physical therapist can help with proper, safe training. During that time, any trauma to the chest should be reported to the surgeon immediately. If CPR is needed, increased force must be used. […] In rare cases, pectus excavatum can recur. […] Is there anything else I need to know to care for my child? Follow up with pulmonary function testing will occur at six months post operatively. Your child should order and wear a Medic Alert bracelet to signify that s/he has a pectus bar in place. This company can be reached by calling: 1888-633-4298 or on line: www.medicalert.org. Your child may go through metal detectors but will likely set off the alarm. You should carry written documentation about the bar along with the Medic Alert bracelet to avoid problems. MRIs may be done after three months, but the scan may not be as clear as necessary due to the bar.

• #129 Pectus excavatum from a pediatric surgeon’s perspective – Nuss- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/11847/html

  The bar should remain in place for 2 to 4 years, but taking into consideration the severity of the chest wall deformity and the age of the patient at the time of removal for optimal timing. […] Ideally, the bar should remain in place for 3 years as there are no recurrences recorded after 36 months. […] While the incidence of congenital pectus excavatum and heritability has not been established yet, what is currently known is that the deformity tends to become more severe as the child grows and the progression is especially significant during the pubertal growth spurt. Close observation during this time period allows the patient and family to be presented with various treatment strategies. All patients are started on an exercise and posture program in order to improve their posture and expand their chest, regardless of whether they are being treated operatively or non-operatively. Vacuum bell therapy may be beneficial for a subset of patients. If the deformity is severe, as judged by specific clinical and objective criteria, then those patients should be offered MIRPE. The procedure is the same for children and adults. Postoperative protocols in the hospital and at home are very important in order to reduce the risk of complications and to improve results. The outcomes are reported as good or excellent by both patients and surgeons in over 98% of the cases, while less than 2% report results as poor, fair, or failed. MIRPE is also associated with high patient satisfaction (i.e., Very Happy or Happy) in over 95% of cases.

• #130 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #131 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  The effects can be so extreme that symptoms occur at rest or cause life-threatening compression of the major blood vessels and organs. The group of patients with physiological impairment usually also suffer from low self-esteem and depression. […] This paper summarizes the current evidence for the different treatment strategies for this condition, including supportive care, psychological support and non-surgical techniques including bracing and vacuum bell therapy. […] For the majority of patients, supportive care is sufficient, but for a minority, a combination of the other techniques may be considered. […] This paper also outlines best practice guidance for the delivery of such therapies, including standardized assessment, consent to treatment, audit, quality assurance and long-term support. […] All the interventions have risks and benefits that the patient, parents and clinicians need to carefully consider and discuss when deciding on the most appropriate course.

• #132 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  We understand that every child is different. Because of this, getting to know each patient, their goals and interests, and how their chest wall affects their daily life is an essential part of care at Boston Children’s. […] From diagnosis to treatment planning and each stage of care, we work to ensure our patients and their families have the best possible experience. This includes making sure we answer all of our patients’ and families’ questions, providing the least invasive treatment options, and — when a patient needs surgery — offering effective pain management and services for a safe return to activity. […] For many children with mild to moderate pectus excavatum or pectus carinatum, vacuum bell therapy or bracing can make surgery unnecessary. We now initiate care with these non-operative techniques and only recommend surgery if the condition persists after treatment. Boston Children’s is one of the first hospitals to offer this plan of care.

• #133 Pectus Excavatum | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pectus-excavatum

  After being discharged from the hospital, your child will follow up in the general surgery clinic in 2-4 weeks. Your child’s surgeon or nurse practitioner will go over pain management and activity restrictions, and any other information you may need to care for your child at home. […] While it is not mandatory to wear a Medical Alert bracelet after surgical correction of pectus excavatum, it is strongly recommended. Information can be provided to you at a post-operative visit on obtaining a Medical Alert bracelet. The inscription on the bracelet should read steel bar in chest, CPR more force, cardioversion ant/post placement.

• #134 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Post operatively your child will have a small tube that puts pain medicine into the spinal fluid (epidural catheter) for 2 3 days. Other medications will be given through the IV, then by mouth. These medications will help to prevent pain, constipation and anxiety and provide muscle relaxation. […] Postoperatively, your child will need to take deep breaths using a device called an incentive spirometer every hour while awake, and will be awakened every two hours during sleep. This is very important to prevent respiratory congestion or pneumonia. […] Positioning may be a challenge for your child. S/he will need to sleep flat on his/her back with only a small pillow under the head. No one should pull on your childs arms during repositioning. Slouching, rolling, side lying, rotation or bending must be avoided. Your child should not attempt to get out of bed or walk without assistance.

• #135 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #136 Pectus Excavatum | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pectus-excavatum

  After being discharged from the hospital, your child will follow up in the general surgery clinic in 2-4 weeks. Your child’s surgeon or nurse practitioner will go over pain management and activity restrictions, and any other information you may need to care for your child at home. […] While it is not mandatory to wear a Medical Alert bracelet after surgical correction of pectus excavatum, it is strongly recommended. Information can be provided to you at a post-operative visit on obtaining a Medical Alert bracelet. The inscription on the bracelet should read steel bar in chest, CPR more force, cardioversion ant/post placement.

• #137 Patient Resources | Descriptions of Pediatric Surgical Procedures

  https://pedsurgla.com/patient_education.php?action=submit&item_id=25

  Are there limitations on sports activities? Yes. No sports until cleared by the surgeon. Usually, aerobic training can start in two months. Competing in non-contact sports can start after three months but football, hockey, kick boxing, soccer and rugby are not recommended at all. […] What are the long-term consequences? The bar will stay in place for 2 4 years. After removal, continuing an exercise program is important. A certified physical therapist can help with proper, safe training. During that time, any trauma to the chest should be reported to the surgeon immediately. If CPR is needed, increased force must be used. […] In rare cases, pectus excavatum can recur. […] Is there anything else I need to know to care for my child? Follow up with pulmonary function testing will occur at six months post operatively. Your child should order and wear a Medic Alert bracelet to signify that s/he has a pectus bar in place. This company can be reached by calling: 1888-633-4298 or on line: www.medicalert.org. Your child may go through metal detectors but will likely set off the alarm. You should carry written documentation about the bar along with the Medic Alert bracelet to avoid problems. MRIs may be done after three months, but the scan may not be as clear as necessary due to the bar.

• #138 Pectus Excavatum | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/pectus-excavatum

  Children will be discharged when they are comfortable on oral pain medication, are eating and drinking without difficulty, and have no fever or signs of an infection. […] Patients who have a Ravitch procedure without a chest strut are seen only as needed after the first postoperative appointment. Ravitch procedure patients with a chest strut or Nuss procedure patients with a bar are seen at least annually after the first visit. […] Narcotic pain management may be required for up to one month after surgery. […] Redness or swelling of the incision(s) should be reported as soon as noted. […] Children who have a pectus bar should call the office for any trauma to the chest, pain or numbness of the arms, or pain that is not relieved by oral medications. […] Physical therapy may be helpful in improving posture. […] Use of a medical alert bracelet or necklace is recommended at all times in order to notify emergency providers of the presence of a Pectus bar.

• #139 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #140 The pectus care guidelines: best practice consensus guidelines from the joint specialist societies SCTS/MF/CWIG/BOA/BAPS for the treatment of patients with pectus abnormalities – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38964837/

  Pectus defects are a group of congenital conditions found in approximately 1 in 250 people, where the sternum is depressed back towards the spine (excavatum), protrudes forwards (carinatum) or more rarely is a mixture of both (arcuatum or mixed defects). […] The majority of defects are mild and are well tolerated, i.e. they do not affect activity and do not cause psychological harm. However, some young people develop lower self-esteem and depression, causing them to withdraw from activities (such as swimming, dancing) and from interactions that might 'expose’ them (such as sleepovers, dating, going to the beach and wearing fashionable clothes). […] This psychological harm occurs at a crucial time during their physical and social development. A small number of patients have more extreme depression of their sternum that impedes their physiological reserve, which can occur when engaging in strenuous exercise (such as running) but can also limit moderate activity such as walking and climbing stairs.

• #141 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #142 Pectus Treatment Program | Pectus Excavatum / Carinatum | CHOC – Pigeon Chest & Funnel Chest Surgery and Procedures

  https://choc.org/programs-services/pediatric-general-surgery/pectus-treatment-program/

  Going through a surgical procedure can be overwhelming. That is why CHOC programs are dedicated to supporting families every step of the way. Our pectus program coordinator, Jacqueline Hurley, will guide families and pectus patients through the treatment process. She helps arrange all medical care, travel plans, appointments and more – she is a complete resource. Thanks to Jacqueline, families at CHOC’s Pectus Treatment Program receive unmatched individualized care. […] The various pediatric experts at CHOC will work together to develop an individualized treatment plan for your child. Through our program, your child will be provided with the exact care they need at the right time.

• #143 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  We understand that every child is different. Because of this, getting to know each patient, their goals and interests, and how their chest wall affects their daily life is an essential part of care at Boston Children’s. […] From diagnosis to treatment planning and each stage of care, we work to ensure our patients and their families have the best possible experience. This includes making sure we answer all of our patients’ and families’ questions, providing the least invasive treatment options, and — when a patient needs surgery — offering effective pain management and services for a safe return to activity. […] For many children with mild to moderate pectus excavatum or pectus carinatum, vacuum bell therapy or bracing can make surgery unnecessary. We now initiate care with these non-operative techniques and only recommend surgery if the condition persists after treatment. Boston Children’s is one of the first hospitals to offer this plan of care.

• #144 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Pectus excavatum is the most common congenital chest wall anomaly, the hallmark of which is the caved-in appearance of the anterior chest. […] The primary objectives of this review are to outline the current practices surrounding the care of pediatric patients with pectus excavatum and present emerging trends in the field that continue to impact the care of these patients. […] This review highlights contemporary management principles of pectus excavatum in the pediatric population, comprising preoperative evaluation, surgical and non-surgical treatment, postoperative considerations including pain control, and monitoring strategies. […] This review also features updated content on non-invasive monitoring and treatment approaches such as three-dimensional (3D) scanning and vacuum bell therapy, which may alter the treatment landscape for pectus excavatum in order to reduce radiation exposure and invasive procedures when able.

• #145 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  Vacuum bell therapy uses a device placed on the chest of a child with pectus excavatum. The device creates suction that slowly pulls the breastbone forward over time. […] We utilize cryoablation during surgery to help minimize post-operative pain. Cryoablation uses cold temperatures to reduce the pain signals sent to the brain. This method of pain management has been proven to reduce the length of patients’ hospital stays, decrease the need for narcotic pain medication, and improve recovery time. […] Patient safety and comfort are our top priorities anytime a chest wall issue requires surgical treatment. We use state-of-the-art equipment in the operating room to ensure your child has the best possible outcome with the lowest possible risk. […] Well before a scheduled surgery, our anesthesiologists meet with our patients and their families to agree on a pain management plan that both the patient and family are comfortable with. During and after the operation, our team of pediatric anesthesiologists work to control pain so that your child has a smooth, comfortable recovery.

• #146 Pectus and Chest Wall Deformities | CHRISTUS Health

  https://www.christushealth.org/get-care/services-specialties/pediatric-care/general-surgery/chest-wall-deformity

  A sunken chest, or pectus excavatum, is a deformity when the breastbone and rib cage sink into the chest, creating a caved-in chest wall deformity. […] The Nuss procedure is a minimally invasive operation. The surgeon inserts one or more curved metal bars under the chest wall. These bars are placed behind the breastbone and push the sunken chest outward, creating a more normal chest shape. The bars are usually left in place for several years to maintain the new shape of the chest as it heals and stabilizes. The operation is known for its high success rate and low risk of complications, including bleeding, infection, bar migration, and cardiac puncture. Patients who undergo this procedure report high levels of satisfaction. […] Surgery to correct the shape of the chest wall can be painful. Fortunately, researchers have made advances in controlling pain. Enhanced Recovery After Surgery (ERAS) protocols help our patients experience less pain, recover more quickly, and return home faster. After surgery, your child cannot participate in sporting events, weightlifting, aerobic exercise, or physical education for at least six weeks. These limitations allow your child’s bars to stabilize in the chest. After six weeks, your surgeon will go through a patient-specific plan for your gradual return to your regular activities. Most patients can return to contact sports three months after surgery.

• #147 Center for Chest Wall Deformities | Connecticut Children’s

  https://www.connecticutchildrens.org/specialties-conditions/pediatric-surgery/center-chest-wall-deformities

  We utilize an enhanced recovery protocol incorporating evidence-based guidelines for pre-operative and post-operative care of pectus excavatum and pectus carinatum. […] Our highly skilled multidisciplinary team integrates medicine and physical therapy with a multi-modal post-operative pain management plan to ensure the highest quality medical care for kids with pectus excavatum and pectus carinatum. […] When indentation of the chest is greater than 2.5 centimeters, internal changes are likely to occur, and surgery may be required to treat your child. […] Connecticut Childrens surgeons use the Nuss Procedure, which is a minimally invasive surgical technique and treatment to correct Pectus Excavatum. During the procedure, a steel bar is placed behind the sternum. The bar remains in place for a minimum of three years to correct the condition. […] We suggest a referral to our department as soon as pectus carinatum becomes visible to optimize treatment for your child.

• #148 Pectus Excavatum – MU Health Care

  https://www.muhealth.org/conditions-treatments/pediatrics/general-surgery/chest-wall-deformities/pectus-excavatum

  In less severe cases, we offer a nonsurgical treatment called the vacuum bell. This is essentially a large suction cup that creates a vacuum seal on your child’s chest wall and lifts the sternum, correcting pectus excavatum over time. […] Our team utilizes an innovative approach to post-operative pain relief using cryoablation. During this procedure, a probe is inserted into the chest using small incisions and temporarily freezes the nerves. Minimal numbness in the chest wall may last up to six months. […] When your child is awake in the recovery room, our nursing team and anesthesiologist work together to ensure he or she is as comfortable as possible. Your child will receive a combination of intravenous (IV) and oral pain medications, muscle relaxants and local anesthetic patches after surgery. We use minimal narcotic pain medications. […] Using these innovative approaches, the average hospital length of stay is usually 2-3 days.

• #149 Center for Chest Wall Deformities | Connecticut Children’s

  https://www.connecticutchildrens.org/specialties-conditions/pediatric-surgery/center-chest-wall-deformities

  We utilize an enhanced recovery protocol incorporating evidence-based guidelines for pre-operative and post-operative care of pectus excavatum and pectus carinatum. […] Our highly skilled multidisciplinary team integrates medicine and physical therapy with a multi-modal post-operative pain management plan to ensure the highest quality medical care for kids with pectus excavatum and pectus carinatum. […] When indentation of the chest is greater than 2.5 centimeters, internal changes are likely to occur, and surgery may be required to treat your child. […] Connecticut Childrens surgeons use the Nuss Procedure, which is a minimally invasive surgical technique and treatment to correct Pectus Excavatum. During the procedure, a steel bar is placed behind the sternum. The bar remains in place for a minimum of three years to correct the condition. […] We suggest a referral to our department as soon as pectus carinatum becomes visible to optimize treatment for your child.

• #150 Pectus and Chest Wall Deformities | CHRISTUS Health

  https://www.christushealth.org/get-care/services-specialties/pediatric-care/general-surgery/chest-wall-deformity

  A sunken chest, or pectus excavatum, is a deformity when the breastbone and rib cage sink into the chest, creating a caved-in chest wall deformity. […] The Nuss procedure is a minimally invasive operation. The surgeon inserts one or more curved metal bars under the chest wall. These bars are placed behind the breastbone and push the sunken chest outward, creating a more normal chest shape. The bars are usually left in place for several years to maintain the new shape of the chest as it heals and stabilizes. The operation is known for its high success rate and low risk of complications, including bleeding, infection, bar migration, and cardiac puncture. Patients who undergo this procedure report high levels of satisfaction. […] Surgery to correct the shape of the chest wall can be painful. Fortunately, researchers have made advances in controlling pain. Enhanced Recovery After Surgery (ERAS) protocols help our patients experience less pain, recover more quickly, and return home faster. After surgery, your child cannot participate in sporting events, weightlifting, aerobic exercise, or physical education for at least six weeks. These limitations allow your child’s bars to stabilize in the chest. After six weeks, your surgeon will go through a patient-specific plan for your gradual return to your regular activities. Most patients can return to contact sports three months after surgery.

• #151 Pectus excavatum – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/care-at-mayo-clinic/mac-20355491

  Pectus excavatum care at Mayo Clinic […] Patients can breathe better after having this corrected it also improves their self-esteem. […] And because we’ve added cryotherapy to our pain management program, we’ve gone from a four to five day hospital stay now to an overnight procedure so people can come in have their surgery and go home the next day. […] We use a minimally invasive cryoablation probe to freeze the intercostal nerves temporarily which results in patients having a very low or no opioid requirement after surgery. […] Ultimately our goal is to get them back home and getting them back to a happy healthy life. […] Specialists in cardiology, pulmonary medicine, thoracic surgery and rehabilitation medicine work together to develop the best treatment plan for you or your child.

• #152 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Young patients may also be referred for vacuum bell therapy as a bridge to potential surgical correction or definitive therapy, as described later. […] Though MIRPE is considered the gold standard treatment for pectus excavatum, there is a need for less invasive treatment modalities that are effective in defect correction and pain management. […] The ideal vacuum bell candidate is relatively young with a flexible chest wall, has a mild to moderate chest wall deformity, and is motivated to be compliant with therapy. […] Pain control following surgical repair of pectus excavatum is often challenging and is a significant contributor to length of stay (LOS). […] Recent advances in protocolized pain management and multimodal pain control have significantly reduced postoperative LOS and narcotic usage after MIRPE. […] Regardless of technique, pediatric patients should be followed postoperatively until they reach full stature to ensure a satisfactory result without unwanted secondary effects of the pectus bar including secondary pectus carinatum or increased costal flaring.

• #153 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Pectus excavatum is the most common congenital chest wall anomaly, the hallmark of which is the caved-in appearance of the anterior chest. […] The primary objectives of this review are to outline the current practices surrounding the care of pediatric patients with pectus excavatum and present emerging trends in the field that continue to impact the care of these patients. […] This review highlights contemporary management principles of pectus excavatum in the pediatric population, comprising preoperative evaluation, surgical and non-surgical treatment, postoperative considerations including pain control, and monitoring strategies. […] This review also features updated content on non-invasive monitoring and treatment approaches such as three-dimensional (3D) scanning and vacuum bell therapy, which may alter the treatment landscape for pectus excavatum in order to reduce radiation exposure and invasive procedures when able.

• #154 The management of pectus excavatum in pediatric patients: a narrative review – Scalise – Translational Pediatrics

  https://tp.amegroups.org/article/view/108944/html

  Pectus excavatum is the most common congenital chest wall anomaly, the hallmark of which is the caved-in appearance of the anterior chest. […] The primary objectives of this review are to outline the current practices surrounding the care of pediatric patients with pectus excavatum and present emerging trends in the field that continue to impact the care of these patients. […] This review highlights contemporary management principles of pectus excavatum in the pediatric population, comprising preoperative evaluation, surgical and non-surgical treatment, postoperative considerations including pain control, and monitoring strategies. […] This review also features updated content on non-invasive monitoring and treatment approaches such as three-dimensional (3D) scanning and vacuum bell therapy, which may alter the treatment landscape for pectus excavatum in order to reduce radiation exposure and invasive procedures when able.

• #155 NUSS Procedure | Pectus Excavatum Surgery | CHOC – Sunken Chest Surgery, Recovery & Survival Rates

  https://choc.org/programs-services/pediatric-general-surgery/pectus-excavatum-sunken-chest-nuss/

  The pectus excavatum team at CHOC is comprised of experts in pediatric pulmonology, cardiology and surgery. The multidisciplinary team performs various tests to examine heart and lung function, before and after surgery. By using the latest techniques in minimally invasive surgery, along with recent improvements in pain management, patients are able to return home and get back to their daily activities sooner than ever before. […] Our CHOC pectus surgeons have been doing the Nuss procedure since 2001 with a very high patient satisfaction and success rate. The pediatric surgeons at CHOC have done more than 300 successful Nuss procedures.

• #156 Pectus excavatum – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/care-at-mayo-clinic/mac-20355491

  Pectus excavatum care at Mayo Clinic […] Patients can breathe better after having this corrected it also improves their self-esteem. […] And because we’ve added cryotherapy to our pain management program, we’ve gone from a four to five day hospital stay now to an overnight procedure so people can come in have their surgery and go home the next day. […] We use a minimally invasive cryoablation probe to freeze the intercostal nerves temporarily which results in patients having a very low or no opioid requirement after surgery. […] Ultimately our goal is to get them back home and getting them back to a happy healthy life. […] Specialists in cardiology, pulmonary medicine, thoracic surgery and rehabilitation medicine work together to develop the best treatment plan for you or your child.

• #157 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  The Pectus and Chest Wall Treatment Program evaluates and treats children and young adults with a wide variety of chest wall deformities. As one of the busiest chest wall treatment programs in the country, we have deep experience in all levels of care: from nonsurgical treatment to minimally invasive surgery, or — when clinically necessary — open surgery. Thanks to our extensive experience, we can ensure each of our patients receives the most appropriate care for their condition. […] Our multi-disciplinary team includes surgeons, nurses, and nurse practitioners, as well as pain management anesthesiologists, certified orthotists, pulmonologists, and cardiologists. And because we are part of Boston Children’s Hospital, ranked among the country’s best hospitals by U.S. News & World Report, our patients have access to a full range of specialized skills and resources to meet their clinical needs.

• #158 Pectus Treatment Program | Pectus Excavatum / Carinatum | CHOC – Pigeon Chest & Funnel Chest Surgery and Procedures

  https://choc.org/programs-services/pediatric-general-surgery/pectus-treatment-program/

  As a leading provider for pectus care, our treatment program for pectus excavatum and pectus carinatum provides your child with the best possible outcomes. Our experienced pediatric chest wall experts use leading-edge pectus procedures focused on reducing recovery time. That way, your child will be back to doing what they love as soon as possible. […] CHOC’s pectus excavatum program brings together a multidisciplinary team of pediatric experts. Your child’s pectus treatment team includes pediatric pulmonologists, cardiologists, pediatric anesthesiologists, pediatric thoracic surgeons and patient mentors. Our program sets the standard in treatment safety and efficacy by assigning two surgeons to every case. Additionally, our cutting-edge pectus excavatum surgery, the Nuss Procedure, allows around 65% of patients to be discharged from the hospital the same day as their surgery. Our specialized focus on pain management during and after pectus surgery gets kids and teens back to enjoying their childhood as quickly as possible.

• #159 Pectus excavatum – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/care-at-mayo-clinic/mac-20355491

  Surgeons may freeze certain nerves during surgery to help provide pain relief during recovery. […] Pediatric and chest surgeons at Mayo Clinic are skilled at performing complex pectus excavatum repair surgeries in both children and adults. […] Highly skilled pediatric experts diagnose and treat all types of conditions in children. […] My piece of advice for other patients who maybe feel alone or scared or like they have nowhere else to turn: Make a phone call to Dr. Jaroszewski fly out here in Phoenix and meet with her. She and her team of cardiologists will make you feel so confident comfortable and help you understand your body more it is scary. Meeting with Dr. Jaroszewski will just reassure you that you’re gonna be okay and you know you’re in the best hands possible.

• #160 Pectus Excavatum | Duke Health

  https://www.dukehealth.org/pediatric-treatments/pectus-excavatum

  Children diagnosed with or suspected of having pectus excavatum receive expert care from Duke pediatric surgeons and nurse practitioners who specialize in treating this chest wall deformity. […] Our providers are trained in testing, monitoring, and treating a sunken chest. We involve you in all decisions about your child’s care and carefully explain our recommendations. […] Recovery can be painful as bones adjust and settle. We will work with you and your child to keep them as comfortable as possible in the days after surgery and will monitor their progress as they heal. […] In the days following surgery, our physical and occupational therapy teams will begin work with your child to help them stand and move on their own comfortably. Additional therapy after your child leaves the hospital is optional. We make sure they regain a safe range of motion, so they can return to regular childhood activities as soon as possible.

• #161 Pectus Treatment Program | Pectus Excavatum / Carinatum | CHOC – Pigeon Chest & Funnel Chest Surgery and Procedures

  https://choc.org/programs-services/pediatric-general-surgery/pectus-treatment-program/

  Going through a surgical procedure can be overwhelming. That is why CHOC programs are dedicated to supporting families every step of the way. Our pectus program coordinator, Jacqueline Hurley, will guide families and pectus patients through the treatment process. She helps arrange all medical care, travel plans, appointments and more – she is a complete resource. Thanks to Jacqueline, families at CHOC’s Pectus Treatment Program receive unmatched individualized care. […] The various pediatric experts at CHOC will work together to develop an individualized treatment plan for your child. Through our program, your child will be provided with the exact care they need at the right time.

• #162 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  Vacuum bell therapy uses a device placed on the chest of a child with pectus excavatum. The device creates suction that slowly pulls the breastbone forward over time. […] We utilize cryoablation during surgery to help minimize post-operative pain. Cryoablation uses cold temperatures to reduce the pain signals sent to the brain. This method of pain management has been proven to reduce the length of patients’ hospital stays, decrease the need for narcotic pain medication, and improve recovery time. […] Patient safety and comfort are our top priorities anytime a chest wall issue requires surgical treatment. We use state-of-the-art equipment in the operating room to ensure your child has the best possible outcome with the lowest possible risk. […] Well before a scheduled surgery, our anesthesiologists meet with our patients and their families to agree on a pain management plan that both the patient and family are comfortable with. During and after the operation, our team of pediatric anesthesiologists work to control pain so that your child has a smooth, comfortable recovery.

• #163 NUSS Procedure | Pectus Excavatum Surgery | CHOC – Sunken Chest Surgery, Recovery & Survival Rates

  https://choc.org/programs-services/pediatric-general-surgery/pectus-excavatum-sunken-chest-nuss/

  The pectus excavatum team at CHOC is comprised of experts in pediatric pulmonology, cardiology and surgery. The multidisciplinary team performs various tests to examine heart and lung function, before and after surgery. By using the latest techniques in minimally invasive surgery, along with recent improvements in pain management, patients are able to return home and get back to their daily activities sooner than ever before. […] Our CHOC pectus surgeons have been doing the Nuss procedure since 2001 with a very high patient satisfaction and success rate. The pediatric surgeons at CHOC have done more than 300 successful Nuss procedures.

• #164 Pectus Excavatum | Duke Health

  https://www.dukehealth.org/pediatric-treatments/pectus-excavatum

  Children diagnosed with or suspected of having pectus excavatum receive expert care from Duke pediatric surgeons and nurse practitioners who specialize in treating this chest wall deformity. […] Our providers are trained in testing, monitoring, and treating a sunken chest. We involve you in all decisions about your child’s care and carefully explain our recommendations. […] Recovery can be painful as bones adjust and settle. We will work with you and your child to keep them as comfortable as possible in the days after surgery and will monitor their progress as they heal. […] In the days following surgery, our physical and occupational therapy teams will begin work with your child to help them stand and move on their own comfortably. Additional therapy after your child leaves the hospital is optional. We make sure they regain a safe range of motion, so they can return to regular childhood activities as soon as possible.

• #165 Center for Chest Wall Deformities | Connecticut Children’s

  https://www.connecticutchildrens.org/specialties-conditions/pediatric-surgery/center-chest-wall-deformities

  We utilize an enhanced recovery protocol incorporating evidence-based guidelines for pre-operative and post-operative care of pectus excavatum and pectus carinatum. […] Our highly skilled multidisciplinary team integrates medicine and physical therapy with a multi-modal post-operative pain management plan to ensure the highest quality medical care for kids with pectus excavatum and pectus carinatum. […] When indentation of the chest is greater than 2.5 centimeters, internal changes are likely to occur, and surgery may be required to treat your child. […] Connecticut Childrens surgeons use the Nuss Procedure, which is a minimally invasive surgical technique and treatment to correct Pectus Excavatum. During the procedure, a steel bar is placed behind the sternum. The bar remains in place for a minimum of three years to correct the condition. […] We suggest a referral to our department as soon as pectus carinatum becomes visible to optimize treatment for your child.

• #166 Pectus excavatum – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/diagnosis-treatment/drc-20355488

  Our caring team of Mayo Clinic experts can help you with your pectus excavatum-related health concerns […] Pectus excavatum treatments include physical therapy, medical devices and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments. […] Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest. […] Treatments that don’t involve surgery may help some people with mild pectus excavatum. They include the following: Physical therapy. Some physical therapy exercises may improve posture and increase the degree to which the chest can expand. […] Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available. These can help connect kids and teens with other young people who have pectus excavatum. […] If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. Then you might be referred to a doctor who does pediatric or chest surgery.

• #167 Pectus Treatment Program | Pectus Excavatum / Carinatum | CHOC – Pigeon Chest & Funnel Chest Surgery and Procedures

  https://choc.org/programs-services/pediatric-general-surgery/pectus-treatment-program/

  Going through a surgical procedure can be overwhelming. That is why CHOC programs are dedicated to supporting families every step of the way. Our pectus program coordinator, Jacqueline Hurley, will guide families and pectus patients through the treatment process. She helps arrange all medical care, travel plans, appointments and more – she is a complete resource. Thanks to Jacqueline, families at CHOC’s Pectus Treatment Program receive unmatched individualized care. […] The various pediatric experts at CHOC will work together to develop an individualized treatment plan for your child. Through our program, your child will be provided with the exact care they need at the right time.

• #168 Pectus Excavatum | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/pectus-excavatum/

  Mild cases of pectus excavatum may be managed with physical therapy and exercises that improve your childs posture and the muscles of the chest, although the chest depression will not change. […] In cases that are moderate to severe, your surgeon may recommend a surgical procedure that will help correct the deformity. There are two main types of surgery that are used to correct pectus excavatum: […] After either procedure, your child will have follow-up visits with the surgeon to ensure that they are healing well and their chest is responding appropriately to surgery. […] The pediatric surgeons at Childrens Hospital Colorado are experienced in evaluating and treating pectus excavatum, both through surgery and through more conservative management. Our teams understand how pectus excavatum can affect your child physically and psychologically. We will walk you through the necessary steps of diagnosis and all the available treatment options. We will continue a relationship with your child in the following years to ensure that they respond well to treatment and have the best outcome possible.

• #169

  https://www.nursingcenter.com/journalarticle?Article_ID=506670&Journal_ID=403341&Issue_ID=506654

  Pectus excavatum is an anterior chest deformity that is characterized by a depressed sternum. […] In addition, there are several important nursing interventions that need to be considered when caring for patients who have undergone surgical repair for pectus excavatum.

• #170 Pectus and Chest Wall Treatment Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/pectus-and-chest-wall-treatment-program

  We understand that every child is different. Because of this, getting to know each patient, their goals and interests, and how their chest wall affects their daily life is an essential part of care at Boston Children’s. […] From diagnosis to treatment planning and each stage of care, we work to ensure our patients and their families have the best possible experience. This includes making sure we answer all of our patients’ and families’ questions, providing the least invasive treatment options, and — when a patient needs surgery — offering effective pain management and services for a safe return to activity. […] For many children with mild to moderate pectus excavatum or pectus carinatum, vacuum bell therapy or bracing can make surgery unnecessary. We now initiate care with these non-operative techniques and only recommend surgery if the condition persists after treatment. Boston Children’s is one of the first hospitals to offer this plan of care.

• #171 Pectus Excavatum | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/pectus-excavatum/

  Mild cases of pectus excavatum may be managed with physical therapy and exercises that improve your childs posture and the muscles of the chest, although the chest depression will not change. […] In cases that are moderate to severe, your surgeon may recommend a surgical procedure that will help correct the deformity. There are two main types of surgery that are used to correct pectus excavatum: […] After either procedure, your child will have follow-up visits with the surgeon to ensure that they are healing well and their chest is responding appropriately to surgery. […] The pediatric surgeons at Childrens Hospital Colorado are experienced in evaluating and treating pectus excavatum, both through surgery and through more conservative management. Our teams understand how pectus excavatum can affect your child physically and psychologically. We will walk you through the necessary steps of diagnosis and all the available treatment options. We will continue a relationship with your child in the following years to ensure that they respond well to treatment and have the best outcome possible.

• #172 Pectus Treatment Program | Pectus Excavatum / Carinatum | CHOC – Pigeon Chest & Funnel Chest Surgery and Procedures

  https://choc.org/programs-services/pediatric-general-surgery/pectus-treatment-program/

  Going through a surgical procedure can be overwhelming. That is why CHOC programs are dedicated to supporting families every step of the way. Our pectus program coordinator, Jacqueline Hurley, will guide families and pectus patients through the treatment process. She helps arrange all medical care, travel plans, appointments and more – she is a complete resource. Thanks to Jacqueline, families at CHOC’s Pectus Treatment Program receive unmatched individualized care. […] The various pediatric experts at CHOC will work together to develop an individualized treatment plan for your child. Through our program, your child will be provided with the exact care they need at the right time.

• #173 Treatments | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/pectus-excavatum/treatments.html

  Our experienced team of chest wall specialists offers the most advanced treatments for pectus excavatum. We work with thoracic surgeons, heart and lung specialists, radiologists, and plastic surgeons to bring you the highest level of care, including minimally invasive options. We also provide compassionate support throughout your care journey. […] Comprehensive support services to help you understand treatment plans and feel better. […] After surgery, we may freeze the nerves of a portion of your chest wall (cryoablation). Cryoablation can help reduce pain and your recovery time.

• #174 Pectus Excavatum: Old Problem, Brief History, New Evidence

  https://oregonpediatricsociety.org/pectus-excavatum-old-problem-brief-history-new-evidence/

  Surgical treatment is the gold standard for severe pectus excavatum. […] Patients with severe pectus excavatum are candidates for the Nuss procedure or MIRPE. Surgery is often done in the early teen years, though can also be offered to adult patients who were not treated in the teen years. […] In summary, there is a safe and effective treatment for teens and adults with pectus excavatum. Failure to treat can lead to long-standing exercise intolerance.

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