Pulmonary function in children with Pectus excavatum and post-operative changes after nuss procedure

Pediatr Surg Int. 2018 Oct;34(10):1099-1103. doi: 10.1007/s00383-018-4319-0. Epub 2018 Aug 6.

Abstract

Purpose: The aim of this study was to show the difference between the pulmonary function of children with mild or severe types of pectus excavatum (PE) and post-operative changes in their predicted vital capacity (%VC) following Nuss procedure.

Patients and methods: One hundred and twenty-four of the 208 children who underwent Nuss procedure for PE between January 2007 and March 2016 were deemed eligible for this study and evaluated retrospectively. A spirometry was performed on these children on four occasions: before operation; pre-bar removal; and 1 month and 1 year after bar removal. Ninety-seven of the children who were more than 7 years of age were divided using the Haller Index (HI) into a mild group (n = 54) and a severe group (n = 43) and compared. The children were also divided into three groups based on their age and their %VC was compared at each follow-up occasion.

Results: The severe group showed a significantly lower %VC and peak expiratory flow rate than the mild group. %VC change after bar removal showed significantly lower in group aged 11 or over. 43 of the children had spirometry data recorded 1 year after bar removal which, compared with 1 month after bar removal, showed a significant higher %VC in groups aged of 10 or under.

Conclusion: Nuss procedure in children aged of 10 or under proved to be an advantage in the post-operative pulmonary function.

Keywords: Nuss procedure; Pectus excavatum; Predicted vital capacity; Pulmonary function; Spirometry.

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Female
  • Funnel Chest / physiopathology*
  • Funnel Chest / surgery*
  • Humans
  • Lung / physiopathology*
  • Male
  • Postoperative Period
  • Retrospective Studies
  • Severity of Illness Index
  • Spirometry
  • Treatment Outcome
  • Vital Capacity