|Other encyclopedia topics:||A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9|
|Contents of this page:|
Alternative Names Return to topFunnel chest repair; Chest deformity repair; Sunken chest repair; Cobbler’s chest repair; Nuss
Definition Return to top
Pectus excavatum repair is surgery to correct pectus excavatum. This is a deformity of the front of the chest wall that causes a sunken breastbone (sternum) and ribs.
Description Return to top
There are 2 types of surgery to repair this condition -- open surgery and closed surgery. Both of these are done while the child is in a deep sleep and pain-free from general anesthesia.
Open surgery is more traditional. In this method, the surgeon makes an incision (cut) across the front part of the chest.
The second type of surgery is a closed, less-invasive method. It is used mostly for children. No cartilage or bone is removed.
Why the Procedure is Performed Return to top
The most common reason for pectus excavatum repair is to improve the appearance of children who feel very self-conscious about the sunken look of their chest wall. Sometimes the deformity is so severe that it affects breathing, especially in adults later in life.
Surgery is usually not done before the age of 6. Best results are seen when the surgery is done before adulthood.
Surgery is usually done on children who are 12 to 16 years old. It can also be done on adults in their early 20s.
Risks Return to top
The risks for any anesthesia are:
The risks for any surgery are:
Risks for this surgery are:
Before the Procedure Return to top
Your child’s surgeon may ask for your child to have:
Always tell your child’s doctor or nurse:
During the days before the surgery:
On the day of the surgery:
After the Procedure Return to top
It is common for children to stay in the hospital for 1 week. How long your child stays will probably depend on their level of discomfort after surgery.
Pain is common after the surgery. For the first few days, your child may receive strong pain medicine through an IV (in the vein) 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 their chest around the incisions. These drain extra fluid that builds up and help the lungs expand. These tubes will remain in place until they stop draining, usually after a few days.
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 all help healing.
At first, your child will not be able to bend, twist, or roll from side to side. The activities they are allowed to do will slowly be increased.
When your child can walk without help, they are probably ready to go home. Before leaving the hospital, you will receive a prescription for pain medicine for your child, to fill at a pharmacy.
Outlook (Prognosis) Return to top
Improvements in appearance are usually good. Improvements in breathing or ability to exercise varies from patient to patient.
References Return to top
Tzelepis GE, McCool FD. The Lungs and Chest Wall Disease. In: Mason RJ, Murray JF, Broaddus VC, Nadel JA. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa; 2005:chap 83.
Sugarbaker DJ, Lukanich JM. Chest Wall and Pleura. In: Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 57.Update Date: 2/22/2009 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.