Materiały źródłowe

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

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

  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. […] Surgery to repair pectus excavatum can ease symptoms and improve how the chest looks. Surgery tends to be a treatment choice for teens and young adults. Surgery may be right for some older people too.

• #1 Pectus Excavatum Treatment

  https://www.rwjbh.org/rwj-university-hospital-new-brunswick/treatment-care/surgery/pectus-excavatum/

  RWJUH offers a wide range of surgical and non-surgical treatment options for both children and adults who suffer from pectus deformities including pectus excavatum and pectus carinatum. […] There are several treatment options for pectus excavatum. Patients with minimal chest deformity can benefit from a program of physical therapy to improve posture and the appearance of the chest thereby avoiding surgery. Surgical treatment may be an option for patients with moderate to severe pectus excavatum, especially when symptoms are present. […] The Nuss procedure is currently the state-of-the-art surgical care for pectus excavatum and is the best option for most patients. […] The Nuss procedure, however, may not be the best option for some patients. As a result, we also offer the Ravitch procedure for patients who cannot be treated with the Nuss procedure.

• #1 Chest wall disorders: When to seek treatment for pectus excavatum or carinatum | Pediatrics | UT Southwestern Medical Center

  https://utswmed.org/medblog/pectus-excavatum-carinatum/

  Most children with pectus carinatum can be treated by wearing a circular brace that gently pushes on the breastbone and remolds the chest by applying measured, gentle pressure. […] Treatment for mild pectus excavatum can include exercises to improve posture and upper body strength. For children with mild to moderate pectus excavatum, vacuum bell therapy may be an option. This nonsurgical treatment uses a sort of suction cup to lift the sunken chest over time. […] For the small percentage of pectus carinatum patients for whom bracing doesnt work and for patients who have pectus excavatum, there are two main surgical options: […] Treatment for pectus excavatum or pectus carinatum can relieve pressure on the heart or lungs and improve breathing, exercise intolerance, and chest pain. […] It also can help your child feel better about their body and more confident at the swimming pool, in the locker room, or during everyday activities.

• #1 Pectus Excavatum Exercises: Improve Strength

  https://www.healthline.com/health/fitness-exercise/pectus-excavatum-exercises

  Pectus excavatum, sometimes called funnel chest, is an abnormal development of the rib cage where the breastbone grows inward. […] Its not preventable but it can be treated. One of the ways to treat it is through exercise. […] According to Anton H. Schwabegger, author of Congenital Thoracic Wall Deformities: Diagnosis, Therapy and Current Developments, pectus exercises include deep breathing and breath-holding exercises, as well as strength training for the back and chest muscles. […] The moves listed below are strengthening and stretching exercises targeting the pectoral and serratus muscles, the back muscles, and the core muscles to improve overall posture. Strengthening these muscles will help with rib flare caused by pectus excavatum and the side effects of it, both physical and cosmetic. […] Exercise is a key component to treating pectus excavatum. By strengthening your chest, back, and core muscles and stretching your chest cavity, you can combat the conditions effects. Aim to complete these exercises several times a week to maximize results.

• #1 Pectus Excavatum Exercises

  https://www.verywellhealth.com/physical-therapy-for-pectus-excavatum-5207912

  Physical therapy exercises for pectus excavatum will likely not cure the condition, but they can help decrease the likelihood of experiencing cardiac and pulmonary problems. They may also help to decrease the need for surgical intervention for pectus excavatum. […] The best way to treat pectus excavatum without surgery is to work on improving the mobility of your thorax, stretching and strengthening the muscles in your chest and back, and maintaining appropriate posture.

• #1 Pectus Excavatum Treatment – Using the Schroth Method

  https://www.integratedpt.info/the-schroth-method-for-pectus-excavatum/

  Pectus excavatum, commonly known as sunken or funnel chest, is a congenital deformity of the chest wall that causes the breastbone to sink inward. […] While surgical intervention is often recommended for severe cases, conservative treatments like the Schroth method have shown promising results in managing mild to moderate cases of pectus excavatum. […] The Schroth method, originally developed in the 1920s by Katharina Schroth, is a conservative treatment approach primarily used for scoliosis, a sideways curvature of the spine. However, it has also been found to be beneficial for individuals with pectus excavatum. […] The Schroth method emphasizes correcting faulty posture associated with the sunken or funnel chest condition. […] The Schroth method utilizes exercises that help stabilize the spine and improve overall body symmetry.

• #1 Pectus Excavatum Treatment – Using the Schroth Method

  https://www.integratedpt.info/the-schroth-method-for-pectus-excavatum/

  Proper breathing plays a crucial role in the Schroth method. […] Several studies have examined the effectiveness of the Schroth method in the management of pectus excavatum. […] The Schroth method has been shown to improve chest wall mobility, enhance lung function, correct postural abnormalities, and alleviate associated discomfort. […] It’s important to note that the Schroth method is typically used as a complementary treatment alongside other interventions for pectus excavatum, such as physical therapy or orthotic bracing. […] The Schroth method offers a non-invasive and conservative approach for managing sunken funnel chest. […] While further research is needed to establish its long-term efficacy, early findings indicate that the Schroth method can contribute to improved symptoms and overall quality of life for individuals with pectus excavatum.

• #1 Vacuum Bell Therapy | Pectus Clinic

  https://www.pectusclinic.com/treatments/vacuum-bell-therapy/

  The vacuum bell device was developed in 2005 by Eckart Klobe, over a decade ago and though not used regularly outside certain centres its has as gained a lot of publicity due to the fact it offers one of the only truly non-surgical treatments for pectus excavatum. […] After an initial consultation we will assess the most appropriate treatment method for your pectus deformity. Whether it be invasive or non-invasive, we ensure your treatment will be of the highest quality, tailored to your individual needs. […] The Vacuum Bell was developed by Eckart Klobe in 2002 and is the only non-surgical treatment for sunken or funnel chest (Pectus Excavatum). It works by lifting the breastbone and front of the ribcage by creating a partial vacuum. […] Treatment with VBT is NOT established within any current recommendations or guidelines but remains a popular non-surgical option in treating flexible Pectus Excavatum as the alternatives are only surgical (corrective surgery such as the Nuss procedure or non-corrective surgery such as a pectus implant).

• #1 Pectus Excavatum | Boston Children’s Hospital

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

  Pectus excavatum is usually diagnosed during a physical examination. X-rays of the chest can help your child’s doctor confirm the diagnosis. At Boston Children’s Hospital, we also use a white light scanner — a type of three-dimensional (3D) camera — to help measure your child’s chest wall depression and monitor their response to treatment over time. […] If your child has a mild case of pectus excavatum, they may not need treatment. A shallow indentation probably will not affect heart or lung function or the appearance of their chest. 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. It typically works best for children who are younger, have mild pectus excavatum, and who have flexible chest walls. Your child will need to wear the device for a total of four hours every day. The therapy usually takes at least two years, but that may depend on your child’s growth.

• #1 Vacuum Bell Therapy | Pectus Clinic

  https://www.pectusclinic.com/treatments/vacuum-bell-therapy/

  „VBT is a safe therapy for treating pectus excavatum in a non-surgical conservative manner with few complications reported. However, the success of VBT is largely dependent on patient compliance and motivation. Permanence of correction after completion of VBT needs to be properly assessed through rigorous follow-up, and currently the success of correction, i.e. permanence, remains in the hands of the patient.” […] The technique is aimed at treating patients, male or female with this type of deformity. […] The Vacuum Bell works by lifting through a partial vacuum the breastbone and anterior chest wall and also stretches internal muscles including the diaphragm so overcoming the tendency of these muscles to pull the ribcage inwards. […] The wearing schedule is based on extensive analysis of the data collected by the Pectus Clinic and knowledge of other VBT programs around the world.

• #1 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. […] A device called a vacuum bell can be used at home. Its placed on your childs chest and is connected to a pump that sucks the air out of the device. This makes a vacuum that pulls the chest forward. Over time, the chest wall stays forward on its own. […] If surgery is needed, doctors may do one of these procedures: The Nuss procedure or minimally invasive repair of pectus excavatum (MIRPE). Minimally invasive means that only a few small incisions (cuts) are needed. The surgeon puts one or more curved metal bars in the chest to push out the breastbone and ribs. […] 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 doesnt look very severe from the outside. Most kids and teens who have treatment do very well and are happy with the results.

• #1 Non-surgical treatment of pectus excavatum – Haecker – Journal of Visualized Surgery

  https://jovs.amegroups.org/article/view/9609/html

  Previously used procedures to correct pectus excavatum (PE) were largely based on surgical techniques like Ravitch procedure or the minimally invasive Nuss technique. Conservative treatment with the vacuum bell (VB) to elevate the funnel in patients with PE, represents a potential alternative to surgery in selected patients. […] The VB has been established as an alternative therapeutic option in selected patients suffering from PE. The initial results proved to be dramatic, but long-term results comprising more than 15 years are so far lacking, and further evaluation and follow-up studies are necessary. […] VB therapy represents a potential alternative to surgery in selected patients. […] Indication for conservative therapy with the VB include patients who present with mild degree of PE, who want to avoid surgical procedure and who are reluctant to undergo surgery because of pain associated with the operation.

• #1 Vacuum Bell Therapy: Does It Cure Pectus Excavatum?TwitterTwitter

  https://www.stephenmcculley.co.uk/resource-centre/other-procedures/vacuum-bell-therapy-cure-pectus-excavatum/

  Vacuum bell therapy can correct pectus excavatum to some extent. Patients with a mild case of symmetric pectus excavatum and a flexible chest wall are most likely to benefit from this therapy. […] The results of vacuum bell therapy will depend on your age and the severity of your pectus excavatum. Vacuum bell therapy is unlikely to have successful results in adults with severe pectus excavatum. […] Vacuum bell therapy should be carried out under the supervision of a doctor or other qualified healthcare practitioner. Therefore it’s not advisable to buy a vacuum bell device and perform the therapy yourself. […] Potential complications and side effects of vacuum bell therapy include: Bruising and swelling, Subcutaneous haematoma—ruptured blood capillaries, Upper back pain, Skin irritation, Transient paresthesia (numb sensation) of the upper extremities.

• #1 The management of pectus excavatum in pediatric patients: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9986778/

  Adverse effects associated with the vacuum bell include sternal pain, skin irritation and hematoma, while contraindications to therapy include musculoskeletal disorders, vasculopathies and coagulopathies. […] Despite the lack of sufficient evidence-based data on complication rates during PBR, several studies have shown the most common complications are wound seroma and pneumothorax.

• #1 Pectus Excavatum – Diagnosis & Treatment

  https://www.upmc.com/services/esophageal-lung-surgery-institute/conditions/pectus-excavatum

  Adults and children with pectus excavatum have a number of treatment options available at the UPMC Esophageal and Lung Surgery Institute. […] Those with the mildest cases of deformity can benefit from physical therapy aimed at improving posture and appearance of the chest, avoiding surgery. People experiencing symptoms, or those with moderate to severe deformity, may need surgery. […] At UPMC, our team of thoracic surgeons uses the minimally invasive Nuss procedure to treat pectus excavatum. […] UPMC thoracic surgeons typically employ this video-assisted thoracoscopic surgery procedure when correcting pectus excavatum on adolescent and adult patients. […] Surgeons typically use traditional surgery to correct pectus excavatum in adults whose symptoms have become severe, or whose deformity negatively impacts their desire to participate in social activities that may expose the chest area. […] Compared to the Nuss procedure, open chest surgery comes at a greater risk and has a longer recovery time.

• #1  Cardiovascular and Thoracic Surgery

  https://www.utmbhealth.com/services/cardiovascular-thoracic-surgery/procedures-conditions/chest-wall-repair/pectus-repair

  The primary goal of pectus excavatum repair surgery is to correct the chest deformity to improve a patient’s breathing, posture and cardiac function. […] UTMB offers the Nuss Procedure to repair pectus excavatum. […] As compared with traditional surgery, patients who undergo laparoscopic or minimally invasive surgery to repair pectus excavatum, such as VATS with the Nuss Procedure, may experience decreased postoperative pain, shorter hospital stay, more rapid recovery and return to work, and other possible benefits include reduced risk of infection and less bleeding.

• #1 The management of pectus excavatum in pediatric patients: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9986778/

  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. […] Young patients may also be referred for vacuum bell therapy as a bridge to potential surgical correction or definitive therapy, as described later. […] The first nonoperative management of pectus excavatum was described by Schier and colleagues in 2005 as the vacuum bell, shown in Figure 2. The device is a suction cup placed over the anterior chest and connected to a patient-activated hand pump used to reduce pressure up to 15% below atmospheric pressure, resulting in sternal elevation.

• #1 Pectus excavatum repair – UF Health

  https://ufhealth.org/conditions-and-treatments/pectus-excavatum-repair

  Pectus excavatum repair is surgery to correct pectus excavatum. This is a congenital (present at birth) deformity of the front of the chest wall that causes a sunken breastbone (sternum) and ribs. […] There are two types of surgery to repair this condition — open surgery and closed (minimally invasive) surgery. Either surgery is done while the child is in a deep sleep and pain-free from general anesthesia. […] The most common reason for pectus excavatum repair is to improve the appearance of the chest wall. […] Surgery is mostly done on children who are 12 to 16 years old, but not before age 6. It can also be done on adults in their early 20s. […] The surgery usually leads to improvements in appearance, breathing, and ability to exercise.

• #1 Pectus Excavatum | Columbia Surgery

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

  Pectus excavatum is a relatively common congenital deformity. […] There are multiple corrective surgeries for pectus excavatum. […] 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.

• #1 Pectus Excavatum and Carinatum Repair – Pediatric Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/pediatric-surgery/clinical-services/pectus-excavatum-and-carinatum-repair

  UCLA Mattel Children’s Hospital is a leading center for treating chest deformities. We provide care for patients from Southern California, across the United States, and around the world. For the best results, we usually recommend surgical correction of chest deformities during early adolescence. This timing helps reduce the chance of the condition coming back later in life. […] Surgery is typically recommended for moderate to severe pectus deformities, especially if the Haller index (a measurement of the chests shape) is greater than 3.2. For reference, a normal Haller index is around 2.5. Surgery may also be considered if the patient has symptoms related to their condition. […] The Ravitch procedure is a well-established surgical method for correcting chest wall deformities. […] The Nuss procedure is a newer method for correcting pectus excavatum. Developed by Dr. Donald Nuss and introduced in 1998, this technique has become very popular for treating this condition.

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

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

  The treatment of pectus excavatum is dependent upon the severity of the defect and your childs 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. […] The Nuss procedure is a minimally invasive technique for surgical repair that involves placement of a concave steel bar under the sternum. At CHOP, the Nuss procedure is the most common surgical procedure for pectus excavatum. Our experienced pediatric surgeons have performed more than 500 Nuss procedures, and typically perform approximately 40 cases each year. […] If your child is a surgical candidate and has twisting (torsion) of the chest, the Ravitch procedure may be a better option.

• #1 Pectus Excavatum: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17328-pectus-excavatum

  Pectus excavatum is a congenital condition, which means you’re born with it. […] Healthcare providers can correct pectus excavatum with minimally invasive surgery or traditional open surgery. […] A surgeon can correct pectus excavatum with a minimally invasive (Nuss procedure) or an open (Ravitch procedure) operation. Your surgeon will discuss which procedure is best for you. During the surgery, your surgeon repositions your sternum (breastbone) to a more outward position. […] Surgery may be right for you if you’re having physical symptoms and/or psychological symptoms from pectus excavatum. The best time for a pectus excavatum repair is between 10 and 14 years of age, when your chest wall is still flexible. Your provider can help you decide the right time for surgery. […] In this minimally invasive procedure, your surgeon will: Insert a camera into your chest to guide the procedure. Make two small incisions on either side of your chest. Insert a custom-curved steel bar(s) under your sternum and position the bar(s) to elevate your sternum. Secure the bar to your chest wall on each side to correct the depression.

• #1 Pectus Excavatum | Boston Children’s Hospital

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

  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. […] The Nuss procedure is minimally invasive surgery in which a surgeon makes small cuts on each side of the chest and inserts a curved bar under the breastbone. The bar, which has been shaped to the contours of your child’s chest, presses the breastbone forward. Sometimes more than one bar is needed. The bar usually remains in the chest for three years while the breastbone grows around it. Removing the bar is a simple procedure. […] The Ravitch procedure, also known as the Welch procedure, is an open surgery in which the surgeon makes a cut across the front of the chest and removes cartilage that is causing the breastbone to grow inward. The surgeon then reshapes the breastbone and may place a metal bar to hold it in place while it heals. The bar usually remains in place for six to 12 months while new cartilage grows.

• #1 Pediatric Pectus Excavatum – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/pectus-excavatum

  In moderate and severe cases, pectus excavatum may require surgery, which has proven very effective at correcting the condition and its psychological and physical effects. […] In moderate and severe cases, pectus excavatum may require surgery, which has proven very effective at correcting the condition and its psychological and physical effects. The most common types of operations are the Nuss procedure and the Ravitch technique. […] The Nuss procedure is more popular because it requires much smaller incisions and is minimally invasive. […] Using the Ravitch technique, surgeons create an incision along the chest, through which they remove cartilage and detach the sternum.

• #1 Pectus Excavatum: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1004953-overview

  A literature review by Maagaard and Heiberg found that patients who underwent correction of pectus excavatum have frequently reported a postoperative increase in exercise stamina, with the outcome apparently unrelated to the specific surgical approach used. […] The acceptance and popularity of MIRPE developed quickly since its introduction in 1997. The principal advantages of this new technique are based on the fact that incising the anterior chest wall, raising the pectoralis muscle flaps, resecting the rib cartilages, and performing a sternal osteotomy are not needed. […] After operative repair of the pectus excavatum, instruct patients on correct posture to eliminate musculoskeletal pain and to prevent worsening of the spinal deformity. Emphasize that repair of the pectus in itself does not result in correction of any associated spinal deformity or problems related to poor posture.

• #1 Pectus Excavatum and Carinatum Repair – Pediatric Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/pediatric-surgery/clinical-services/pectus-excavatum-and-carinatum-repair

  The bar is secured with stitches and stays in place for 2 to 3 years to help reshape the chest. […] The Nuss procedure is usually quicker than the Ravitch procedure. It leads to less blood loss, smaller incisions, and minimal scarring. Recovery time is faster than traditional methods, with a usual hospital stay of 1 to 2 days.

• #1 Adult Chest Wall Surgery Program | Department of Cardiothoracic Surgery | Stanford Medicine

  https://med.stanford.edu/ctsurgery/clinical-care/thoracic-surgery-services/adult-chest-wall-surgery-program.html

  Pectus excavatum is a congenital deformity of the bones and cartilage of the chest where several ribs and the breastbone (sternum) grow in an inward direction resulting in a sunken appearance of the center of the chest. […] Most cases are diagnosed in the early teenage years during growth spurts and severe cases are usually offered surgical correction prior to adulthood. […] Surgery is only recommended for those patients when we are extremely confident that the patient will be much improved after their recovery from surgery. […] The mainstay of surgical repair of pectus excavatum has been the Ravitch procedure initially performed in the 1940s and still performed today in a modified form. […] The Nuss procedure, also known as Minimally Invasive Repair of Pectus Excavatum (MIRPE), has the advantages of smaller incisions on the side of the chest rather than the middle, avoidance of cartilage or bone removal and has proved popular in the pediatric population. […] Deciding which procedure is right for you requires a detailed examination and discussion with an expert in performing both. […] The Stanford Adult Pectus Program provides surgical care to patients requiring primary repair and revisional surgery for pectus excavatum in adults.

• #1 Pectus Excavatum: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17328-pectus-excavatum

  In this traditional or open procedure, your surgeon will: Make an incision on the front of your chest. Remove the overgrown connective tissue that’s pushing your sternum backward. Pull your sternum forward, away from your heart and lungs, into your chest wall. Use a small plate and tiny screws or a small metal bar to stabilize your sternum in its new position. […] Both the Nuss procedure and the modified Ravitch technique are safe and effective procedures. But complications, although rare, can happen. […] With advances in pain management, recovery from surgery is shorter and less painful now than it used to be. […] Using cryoablation to minimize severe pain after the Nuss procedure significantly shortens hospital stays and reduces the need for opioids. […] After surgery, you’ll need to take it easy for a while due to discomfort. You can walk and run again when discomfort permits. Your surgeon will determine when you can resume heavy lifting and competitive sports. […] Both the Nuss and Ravitch procedures have excellent results. People are almost always satisfied with the way they feel and look after recovery. The rate of the condition recurring (happening again) is less than 1% for both procedures.

• #1 Pectus excavatum | Children’s Wisconsin

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

  The Ravitch procedure predates the Nuss procedure by 42 years. […] Recovery is often 3-5 days in hospital with 2 drains that are removed a few days after surgery. […] Results are excellent, and this approach may be preferred by adult excavatum patients who will have an easier recovery from such an approach.

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

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

  After about three years, the bar is removed in a same-day procedure. This pectus excavatum repair is highly effective. Less than 1 percent of children will develop the condition again. […] Cryoablation is a newer method of pain management for people undergoing bar placement to repair pectus excavatum. It can dramatically reduce pain after surgery. […] Pain control from cryoablation should reduce your child’s need for additional pain medications after the first few days after surgery.

• #1 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. […] For patients with pectus excavatum which is severe or those whose condition does not improve through non-surgical treatment, we offer a minimally invasive repair known as the Nuss procedure. […] 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.

• #1 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.

• #1 Pectus Up New Generation – Pectus Up

  https://pectusup.com/en/pectus-up-surgery-kit/

  The Pectus Up technique was first performed in 2012 in Barcelona, Spain. […] The implantable kit consists of two essential components: the lifting plate, which is positioned over the rib crest within the subpectoral space, and the sternal plate, which is anchored to the sternum using fixation screws. […] Utilizing a specialized elevation system composed of advanced surgical instruments, the sternum is elevated through an extrathoracic approach. […] This maneuver enables precise alignment of the sternal plate with the lifting plate. […] Once both components are securely fixed, the anatomical correction of Pectus Excavatum is achieved with optimal stability and minimal invasiveness. […] Minimally invasive: Only a small incision is required to insert the implant. […] Extrathoracic procedure: The plate is implanted outside the chest cavity, avoiding the risk of damaging internal organs.

• #1 Pectus Up New Generation – Pectus Up

  https://pectusup.com/en/pectus-up-surgery-kit/

  Minimal postoperative pain: Generally, only conventional pain relief is required. […] No risk to vital organs: Being extrathoracic, it does not affect the heart or lungs. […] Quick surgical intervention: Due to the lower complexity of the procedure. […] Short hospital stay: The patient is hospitalized for only a few days. […] Rapid integration into daily life: A minimally invasive procedure with a short recovery time. […] Due to the ease of the Pectus Up New Generation technique, adult patients and cases with a high degree of asymmetry have a great opportunity to correct their Pectus Excavatum very satisfactorily. […] Innovative surgical method that guarantees a minimally invasive extrathoracic solution for the correction of Pectus Excavatum.

• #1 Pectus Excavatum: Symptoms, Treatments, and Complications

  https://www.healthline.com/health/pectus-excavatum

  Pectus excavatum treatments depend on how severe a persons chest cave is. If a person is having breathing or heart problems, their doctor will likely recommend surgery. Other treatments include exercises to improve breathing and posture. […] Some people may also benefit from vacuum bell therapy. This type of therapy involves a person using a special pump applied against the chest wall for anywhere from 30 minutes to several hours. The pump creates negative pressure on the chest that can elevate the chest wall to reduce the incidence of sunken chest. […] Doctors are evaluating a new technique called the magnetic mini-mover procedure. This experimental procedure involves implanting a powerful magnet within the chest wall. A second magnet is attached to the outside of the chest. […] Certain exercises, such as deep breathing exercises and those designed to improve posture, may help people with mild-to-moderate sunken chest who dont want to have surgery. These approaches can help reduce their symptoms.

• #1 Pectus Excavatum | UCSF Department of Surgery

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

  Both of the Ravitch and Nuss procedures require big operations and hospitalization for pain management. The fundamental problem with both techniques is that they attempt to correct a significant rigid chest wall deformity all at once, i.e., in a single surgical procedure. Perhaps a better principle for correction of chest wall and other deformities is by gradual (bit-by-bit) correction using minimal force applied over many months. This is the same principle used in moving teeth with orthodontic braces. […] In an effort to overcome these problems, we have developed a novel method of achieving gradual deformation/reformation of chest wall cartilage without the need for insertion of painful orthopedic devices or repeated surgeries. We call this new technique the Magnetic Mini Mover Procedure (3MP).

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

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

  Most people who have surgery to correct pectus excavatum are happy with the change in how their chests look. Studies found that to be true no matter which of the two surgeries people had. […] Other treatments aim to improve only the appearance of the chest. These are called cosmetic treatments. They’re mainly for people who have mild pectus excavatum without meaningful symptoms. A healthcare professional can place a silicon implant in the chest to fill in the sunken area. Or shots of certain dermal fillers may help fill in the area.

• #1 Treatments | Pectus Clinic

  https://www.pectusclinic.com/treatments/

  The treatment options discussed will depend on the type and severity of the pectus deformity. […] In many cases, treatment may involve more than one option. […] Exercise and posture management is likely to help some of the associated problems with 'pectus posture’ but alone there is less certain evidence of successfully treating the pectus deformity particularly more severe forms. […] The role of bracing for compliant pliable pectus carinatum has been used worldwide for several decades and is well established as standard treatment in many countries. […] The vacuum bell offers a non-surgical treatment of pectus excavatum. […] It can be used as both an alternative to surgical treatment of pectus excavatum. […] Used typically to treat forms of pectus excavatum it involves placing a prosthetic implant under the skin in front of the breast bone to mask the deformity and therefore is a relatively minor surgical procedure.

• #1 Nuss Procedure: Treatment for Pectus Excavatum

  https://my.clevelandclinic.org/health/treatments/22635-nuss-procedure

  A Nuss procedure treats pectus excavatum, a condition in which your chest bones didnt develop right. This is a congenital condition or one youve had since birth. One in 1,000 people will develop pectus excavatum. […] A Nuss procedure straightens your childs chest wall. Most children who have this procedure get a normal chest shape thats visible right after surgery. After a Nuss procedure, most people can breathe and exercise better. […] It takes about six months for full recovery from the Nuss procedure, but most people are back to usual activities (except for heavy lifting and contact sports) much sooner. Activities that involve twisting your body or raising your arms a lot can move the bar out of place. This is why your child will need some time to recover from surgery before returning to physical activities.

• #1 Pectus Excavatum | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/p/pectus-excavatum

  Minimally invasive surgical techniques have been used for more than three decades. With this approach, two small lateral incisions are made. A bar that has been shaped to the desired chest contour is inserted into and across the chest and positioned below the sternum. This is done using the guidance of an endoscope (instrument used to visualize the inside of the chest). The bar is held in place by sutures and by a small metal plate that prevents rotation of the bar as the chest is reshaped. […] In our experience, short-term outcomes with minimally invasive surgery are at least comparable to outcomes with open surgery. They result in a better cosmetic outcome with less scarring (due to smaller incisions), good restoration of normal chest contour, and good muscle function. Long-term outcomes currently appear to be as good as those with traditional open surgery. […] There is no need to restrict exercise or activity after the initial healing period. Patients are encouraged to exercise in order to improve overall chest growth and contour and to increase the strength of their chest muscles.

• #1 Pectus Excavatum Repair – Alder Hey Children’s Hospital Trust

  https://www.alderhey.nhs.uk/conditions/patient-information-leaflets/pectus-excavatum-repair/

  You will be encouraged to drink as soon as you have recovered from the anaesthetic. […] Antibiotics will be given after surgery to help prevent infection. […] Physiotherapists will make regular visits and give you some information on exercises to help with breathing and circulation, plus upper limb and postural correction exercises will be started the day after your surgery. […] Patients can usually be discharged 4-5 days after surgery. […] It is very important that you continue with the exercises advised by physiotherapy when you return home. […] You will need to take it easy for the first four to six weeks after surgery. […] You will be given paracetamol and diclofenac to take home on discharge. Continue both regularly for the first 2-3 weeks after surgery to minimise any pain. […] Further appointments will be given at 3 months, 6 months and every 12 months until bar removal.

• #1 Pectus excavatum – Wikipedia

  https://en.wikipedia.org/wiki/Pectus_excavatum

  Surgical correction of the pectus excavatum has been shown to significantly improve cardiovascular function; there is inconclusive evidence so far as to whether it might also improve pulmonary function. […] The Nuss procedure involves slipping in one or more concave steel bars into the chest, underneath the sternum. […] The bar is flipped to a convex position so as to push outward on the sternum, correcting the deformity. […] The Ravitch technique is an invasive surgery that was introduced in 1949 and developed in the 1950s. […] The Robicsek procedure is a single-stage procedure (one surgery only). […] The Wang procedure, pioneered by Dr. Wenlin Wang in 2017, is an innovative surgical approach aimed at treating pectus excavatum across different age groups. […] Pectus up technique was developed to be an alternative to the Nuss procedure that eliminates the risks and drawbacks of entering the thorax. […] The implant allows pectus excavatum to be treated from a purely morphological perspective.

• #1 Pectus Excavatum: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1004953-overview

  Pectus excavatum, also known as sunken or funnel chest, is a congenital chest wall deformity in which several ribs and the sternum grow abnormally, producing a concave, or caved-in, appearance in the anterior chest wall. […] The prognosis of pectus excavatum, with treatment, is excellent. Patients with mild pectus excavatum who do not undergo operative correction also have an excellent prognosis. Patients with moderate-to-severe pectus excavatum may experience problems related to cardiopulmonary impairment, decreased exercise tolerance, decreased stamina, and adjustment disorders related to the impact of this deformity on body image and coping mechanisms. […] A prospective study by Lomholt et al indicated that physical and psychosocial health-related quality of life (HRQL) improves in children following surgery for pectus excavatum.

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

  https://www.annalscts.com/article/view/11847/12234

  Exercise restriction is mandatory for the first six weeks with slow resumption of normal activity after 12 weeks. […] Our recommendation is to offer pectus excavatum repair provided the patient fulfills two or more of the following criteria: Severe and progressive deformity with associated symptoms (e.g., shortness of breath, chest pain, exercise intolerance); Chest computed tomography (CT) scan demonstrating a Haller index greater than 3.25 and showing cardiac compression or displacement; […] If the deformity is severe, as judged by specific clinical and objective criteria, then those patients should be offered MIRPE. […] The operation is discussed in detail in the manuscript titled Nuss Procedure: Past, Present and Future in this issue of the Journal. […] The post-operative management protocols are similar for children as for older patients. […] 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.

• #1 Treatments | Stanford Health Care

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

  Pectus Excavatum Treatments […] 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. […] Types of Pectus Excavatum Treatment […] If you have mild pectus excavatum with no symptoms, you may not need treatment. But if you have symptoms that affect your heart or breathing, or if you’re not happy with the appearance of your chest, treatment may benefit you. […] Treatment for pectus excavatum depends on several factors, including: […] Severity of your symptoms […] Our doctors will suggest the most appropriate treatment for your situation. Treatments we offer include:

• #1 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. […] Vacuum bell therapy may make surgery unnecessary. […] 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.

• #1 Pectus Excavatum | Boston Children’s Hospital

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

  Most children with pectus excavatum don’t need any treatment at all. In severe cases, repairing the chest wall may help the function of the heart and lungs. But in most cases, the biggest benefits of treatment are psychological. If your child is upset by their chest’s appearance, treatment can make a big difference in their self-confidence. […] The Pectus and Chest Wall Treatment Program at Boston Children’s Hospital evaluates and treats infants, children, and young adults using state-of-the-art operative and non-operative methods to improve the quality of life for each child entrusted to our care. […] If pectus excavatum causes physical or social problems, we initiate a treatment plan designed for your child’s specific anatomy and preferences. If your child is young and able to wear a vacuum bell daily, we will fit them to the correct vacuum bell device and monitor their response to treatment over time. If your child has severe pectus excavatum, is older, or does not improve with vacuum bell therapy, we may offer surgery.

• #1 Treatments | Stanford Health Care

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

  Surgery If you have severe pectus excavatum (a Haller index of more than 3.2), we may recommend surgery. Pectus excavatum repair can improve breathing and heart problems. It can also correct the indentation of your sternum to improve your appearance. […] Many patients with severe pectus excavatum have surgery to correct it while they are children. Surgical repair in adults can be more complicated. Previous procedures, including breast surgery or breast implants, and factors such as calcified cartilage, can affect pectus excavatum surgery. […] Surgeons in our Adult Pectus Program can modify techniques to offer safe surgical options for adult patients. We also offer surgical repair (revision surgery) to adults who have had previous surgery for pectus excavatum. Pectus excavatum surgery techniques we offer include:

• #1 Minimally invasive repair of pectus excavatum in adults: a review article of presentation, workup, and surgical treatment – Aly – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/76367/html

  As more experience with adult pectus repair accumulates, criteria for repair are likely to evolve. […] The MIRPE technique has gained widespread popularity because of its minimally invasive approach, as evidenced by small skin incisions, no need for cartilage resection, short operative time, minimal blood loss and comparable postoperative morbidity with respect to the modified Ravitch procedure. […] With these technique modifications, successful MIRPE has been reported in adults up to the age of 72 years old, with surgery resulting in resolution of symptoms, improved quality of life, and satisfying results. […] Most recent publications by experienced centers have shown that MIRPE is safely performed in adult patients with minimal blood loss, shorter operating times, and relatively few postoperative complications.

• #1 The management of pectus excavatum in pediatric patients: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9986778/

  Pectus excavatum is the most common congenital chest wall anomaly, the hallmark of which is the caved-in appearance of the anterior chest. A growing body of literature exists surrounding methods of surgical correction, though considerable variability in management remains. 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.

• #1 Non-surgical treatment of pectus excavatum – Haecker – Journal of Visualized Surgery

  https://jovs.amegroups.org/article/view/9609/html

  The VB therapy may allow some patients with PE to avoid surgery. Especially patients with symmetric and mild PE may benefit from this procedure. The application is easy, and we noticed a good acceptance by both paediatric and adult patients. However, the time of follow-up with a maximum of 10 years is still not long enough, and further follow-up studies are necessary to evaluate the effectiveness of this therapeutic tool. Additionally, more differentiated analysis must focus on age and gender specific differences. The results of ongoing studies will enable us to answer at least some of these questions. The intraoperative use of the VB during the MIRPE facilitates the introduction of the pectus bar. In any case, the method seems to be a valuable adjunct therapy in the treatment of PE.

• #1 Current Management of Pectus Excavatum: A Review and Update of Therapy and Treatment Recommendations | American Board of Family Medicine

  https://www.jabfm.org/content/23/2/230

  Pectus excavatum (PE) is a posterior depression of the sternum and adjacent costal cartilages and is frequently seen by primary care providers. […] Evidence continues to present that these physiologic impairments may worsen as the patient ages. Data reports improved cardiopulmonary function after repair and marked improvement in psychosocial function. […] More recent consensus by both the pediatric and thoracic surgical communities validates surgical repair of the significant PE and contradicts arguments that repair is primarily cosmetic. […] Surgical correction of PE can be performed safely with minimal risk. Referral for consideration of surgical treatment for severe cases should be made. […] Operation for correction of PE is readily accomplished in teenagers, who are close to the age of skeletal maturity.

• #2 Pectus Excavatum: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17328-pectus-excavatum

  Pectus excavatum is a congenital condition, which means you’re born with it. […] Healthcare providers can correct pectus excavatum with minimally invasive surgery or traditional open surgery. […] A surgeon can correct pectus excavatum with a minimally invasive (Nuss procedure) or an open (Ravitch procedure) operation. Your surgeon will discuss which procedure is best for you. During the surgery, your surgeon repositions your sternum (breastbone) to a more outward position. […] Surgery may be right for you if you’re having physical symptoms and/or psychological symptoms from pectus excavatum. The best time for a pectus excavatum repair is between 10 and 14 years of age, when your chest wall is still flexible. Your provider can help you decide the right time for surgery. […] In this minimally invasive procedure, your surgeon will: Insert a camera into your chest to guide the procedure. Make two small incisions on either side of your chest. Insert a custom-curved steel bar(s) under your sternum and position the bar(s) to elevate your sternum. Secure the bar to your chest wall on each side to correct the depression.

• #2 Current Management of Pectus Excavatum: A Review and Update of Therapy and Treatment Recommendations | American Board of Family Medicine

  https://www.jabfm.org/content/23/2/230

  Currently, most surgeons will wait for patients to reach the adolescence or early teenage years to perform repair. […] Surgical repair of PE has evolved significantly during the past 50 years. […] The technique resects minimal cartilage and yields excellent results with low morbidity. […] A minimally invasive technique for repair was described by Nuss et al in 1998. […] The advantages of the Nuss approach include avoiding an anterior chest wall incision, resection of rib cartilages, and no sternal osteotomy. […] Several studies have compared the 2 methods. […] Overall, there seems to be no significant advantage for either approach. […] Innovative, nonsurgical approaches are also under development and evaluation, including vacuum treatment and the use of magnetic forces. […] The philosophy of PE deformity has evolved as more data and treatment experience has accrued. PE is no longer felt to be just a cosmetic deformity but physicians may continue to base their recommendations for surgery on limited and preconceived knowledge from the past. […] The cardiopulmonary effects of severe deformities can be significant and may worsen as the patient ages. Surgery can be performed safely with few complications and short hospitalization.

• #2 Pectus Excavatum Exercises

  https://www.verywellhealth.com/physical-therapy-for-pectus-excavatum-5207912

  Pectus excavatum is a condition in which your sternum (breastbone) has sunk into your chest cavity. […] In severe cases, the caving in of the sternum may compress structures in your chest, causing heart problems or difficulties with lung function. In those cases, surgery may be recommended to correct the problem. […] If you have pectus excavatum, you may benefit from the skilled services of a physical therapist. While the therapy you receive will not cure your condition, it can instruct you on what to do to maintain high levels of cardiac and pulmonary (heart and lung) function. […] Performing the correct exercises for your condition under the guidance of a physical therapist may help you prevent loss of mobility and loss of cardiac or lung function, and it may prevent the need for surgical intervention.

• #2 Vacuum Bell Therapy | Pectus Clinic

  https://www.pectusclinic.com/treatments/vacuum-bell-therapy/

  „VBT is a safe therapy for treating pectus excavatum in a non-surgical conservative manner with few complications reported. However, the success of VBT is largely dependent on patient compliance and motivation. Permanence of correction after completion of VBT needs to be properly assessed through rigorous follow-up, and currently the success of correction, i.e. permanence, remains in the hands of the patient.” […] The technique is aimed at treating patients, male or female with this type of deformity. […] The Vacuum Bell works by lifting through a partial vacuum the breastbone and anterior chest wall and also stretches internal muscles including the diaphragm so overcoming the tendency of these muscles to pull the ribcage inwards. […] The wearing schedule is based on extensive analysis of the data collected by the Pectus Clinic and knowledge of other VBT programs around the world.

• #2 Living With Mild Pectus Excavatum | University of Utah Health

  https://healthcare.utah.edu/healthfeed/2024/03/living-mild-pectus-excavatum

  If your condition is mild and you do choose to treat it, you have a couple of non-surgical options. […] Vacuum bell therapy: A vacuum bell is essentially a very large suction cup that that you wear on the front of the chest for several hours each day. Its attached to a pump that creates suction and pulls the breastbone forward. […] Physical therapy: While physical therapy wont cure pectus excavatum, it can help you improve posture, strength, and mobility. Maintaining good posture and upper body strength can help prevent your condition from worsening. […] If you or your child receives a diagnosis of mild pectus excavatum, dont stress. Non-surgical options can help their condition if they need it, but they can live a healthy and full life with it untreated.

• #2 The management of pectus excavatum in pediatric patients: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9986778/

  Adverse effects associated with the vacuum bell include sternal pain, skin irritation and hematoma, while contraindications to therapy include musculoskeletal disorders, vasculopathies and coagulopathies. […] Despite the lack of sufficient evidence-based data on complication rates during PBR, several studies have shown the most common complications are wound seroma and pneumothorax.

• #2 Pectus Excavatum and Carinatum Repair – Pediatric Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/pediatric-surgery/clinical-services/pectus-excavatum-and-carinatum-repair

  UCLA Mattel Children’s Hospital is a leading center for treating chest deformities. We provide care for patients from Southern California, across the United States, and around the world. For the best results, we usually recommend surgical correction of chest deformities during early adolescence. This timing helps reduce the chance of the condition coming back later in life. […] Surgery is typically recommended for moderate to severe pectus deformities, especially if the Haller index (a measurement of the chests shape) is greater than 3.2. For reference, a normal Haller index is around 2.5. Surgery may also be considered if the patient has symptoms related to their condition. […] The Ravitch procedure is a well-established surgical method for correcting chest wall deformities. […] The Nuss procedure is a newer method for correcting pectus excavatum. Developed by Dr. Donald Nuss and introduced in 1998, this technique has become very popular for treating this condition.

• #2 Zimmer Biomet | Treatment Options For Pectus Excavatum

  https://pectusbar.com/surgical-treatment-options/

  A Nuss Procedure generally follows these steps: Two small incisions (usually 2 inches in length), one on either side of the chest, are made to provide access under the sternum. […] Talk to your surgeon about whether the MIRPE/Nuss procedure is right for you and the risks of the procedure, including the risk of implant wear, loosening or failure, and pain, swelling and infection.

• #2 Pectus Excavatum | Boston Children’s Hospital

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

  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. […] The Nuss procedure is minimally invasive surgery in which a surgeon makes small cuts on each side of the chest and inserts a curved bar under the breastbone. The bar, which has been shaped to the contours of your child’s chest, presses the breastbone forward. Sometimes more than one bar is needed. The bar usually remains in the chest for three years while the breastbone grows around it. Removing the bar is a simple procedure. […] The Ravitch procedure, also known as the Welch procedure, is an open surgery in which the surgeon makes a cut across the front of the chest and removes cartilage that is causing the breastbone to grow inward. The surgeon then reshapes the breastbone and may place a metal bar to hold it in place while it heals. The bar usually remains in place for six to 12 months while new cartilage grows.

• #2 Nuss Procedure: Treatment for Pectus Excavatum

  https://my.clevelandclinic.org/health/treatments/22635-nuss-procedure

  A Nuss procedure is a minimally invasive surgery that corrects pectus excavatum, or a sunken chest. This procedure, which has a high success rate, uses one or more metal bars to push a childs breastbone forward to where it belongs. It takes six months to recover fully. […] A Nuss procedure is a minimally invasive surgical repair to fix pectus excavatum. People who have this sunken chest issue are candidates for the Nuss procedure instead of an open repair with a larger incision. The procedure uses a titanium bar or bars to push a childs sunken breastbone out. Bars stay in your chest for three years. […] A Nuss procedure makes a sunken chest, called pectus excavatum, look better right away. The bar pushes your breastbone forward to flatten your chest. While the bar is in place, it helps your breastbone grow in the right way. This procedure can help your heart or lungs work better than they do prior to surgery.

• #2 Pediatric Pectus Excavatum – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/pectus-excavatum

  In moderate and severe cases, pectus excavatum may require surgery, which has proven very effective at correcting the condition and its psychological and physical effects. […] In moderate and severe cases, pectus excavatum may require surgery, which has proven very effective at correcting the condition and its psychological and physical effects. The most common types of operations are the Nuss procedure and the Ravitch technique. […] The Nuss procedure is more popular because it requires much smaller incisions and is minimally invasive. […] Using the Ravitch technique, surgeons create an incision along the chest, through which they remove cartilage and detach the sternum.

• #2 Pectus Excavatum | Columbia Surgery

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

  The minimally invasive Nuss procedure is performed with general anesthesia. […] Many adults have undergone minimally invasive pectus repair with the Nuss procedure, which was originally developed for the repair of pectus excavatum in children. […] The modified Ravitch technique involves removing small pieces of deformed chest cartilage and repositioning the protruding ribs and sternum. To support the repaired chest architecture, titanium bars are secured to the ribs and sternum.

• #2 Pectus excavatum evaluation, surgery – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/pectus-excavatum-hollow-chest

  While children can be self-conscious about the shape of the chest, most patients are healthier after surgery to correct pectus excavatum. After the sternum is put in the correct position using a metal bar, children may have improved breathing and increased endurance with exercise. […] Prior to surgical advancements, recovery used to include being in bed for five days after the surgery in the hospital. Now, most patients leave the next day after surgery. This is due to cryotherapy, which treats the nerves on each side of the body and decreases the use of narcotic pain medicine after leaving the hospital.

• #2 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.

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

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

  Most people who have surgery to correct pectus excavatum are happy with the change in how their chests look. Studies found that to be true no matter which of the two surgeries people had. […] Other treatments aim to improve only the appearance of the chest. These are called cosmetic treatments. They’re mainly for people who have mild pectus excavatum without meaningful symptoms. A healthcare professional can place a silicon implant in the chest to fill in the sunken area. Or shots of certain dermal fillers may help fill in the area.

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

  https://www.annalscts.com/article/view/11847/12234

  Exercise restriction is mandatory for the first six weeks with slow resumption of normal activity after 12 weeks. […] Our recommendation is to offer pectus excavatum repair provided the patient fulfills two or more of the following criteria: Severe and progressive deformity with associated symptoms (e.g., shortness of breath, chest pain, exercise intolerance); Chest computed tomography (CT) scan demonstrating a Haller index greater than 3.25 and showing cardiac compression or displacement; […] If the deformity is severe, as judged by specific clinical and objective criteria, then those patients should be offered MIRPE. […] The operation is discussed in detail in the manuscript titled Nuss Procedure: Past, Present and Future in this issue of the Journal. […] The post-operative management protocols are similar for children as for older patients. […] 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.

• #2 Adult Chest Wall Surgery Program | Department of Cardiothoracic Surgery | Stanford Medicine

  https://med.stanford.edu/ctsurgery/clinical-care/thoracic-surgery-services/adult-chest-wall-surgery-program.html

  Pectus excavatum is a congenital deformity of the bones and cartilage of the chest where several ribs and the breastbone (sternum) grow in an inward direction resulting in a sunken appearance of the center of the chest. […] Most cases are diagnosed in the early teenage years during growth spurts and severe cases are usually offered surgical correction prior to adulthood. […] Surgery is only recommended for those patients when we are extremely confident that the patient will be much improved after their recovery from surgery. […] The mainstay of surgical repair of pectus excavatum has been the Ravitch procedure initially performed in the 1940s and still performed today in a modified form. […] The Nuss procedure, also known as Minimally Invasive Repair of Pectus Excavatum (MIRPE), has the advantages of smaller incisions on the side of the chest rather than the middle, avoidance of cartilage or bone removal and has proved popular in the pediatric population. […] Deciding which procedure is right for you requires a detailed examination and discussion with an expert in performing both. […] The Stanford Adult Pectus Program provides surgical care to patients requiring primary repair and revisional surgery for pectus excavatum in adults.

• #2 Treatments | Stanford Health Care

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

  Surgery If you have severe pectus excavatum (a Haller index of more than 3.2), we may recommend surgery. Pectus excavatum repair can improve breathing and heart problems. It can also correct the indentation of your sternum to improve your appearance. […] Many patients with severe pectus excavatum have surgery to correct it while they are children. Surgical repair in adults can be more complicated. Previous procedures, including breast surgery or breast implants, and factors such as calcified cartilage, can affect pectus excavatum surgery. […] Surgeons in our Adult Pectus Program can modify techniques to offer safe surgical options for adult patients. We also offer surgical repair (revision surgery) to adults who have had previous surgery for pectus excavatum. Pectus excavatum surgery techniques we offer include:

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