Repair of the pectus deformity: Results of the Ravitch approach in the current era

• Published in: The Annals of thoracic surgery Vol. 78; no. 2; pp. 421 - 426
• Main Authors: Davis, J.Terrance, Weinstein, Samuel
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2004; Elsevier Science
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiology. Vascular system; Cartilage - abnormalities; Cartilage - surgery; Child; Child, Preschool; Device Removal - economics; Female; Funnel Chest - economics; Funnel Chest - surgery; Hospital Costs; Humans; Length of Stay - statistics & numerical data; Male; Medical sciences; Middle Aged; Minimally Invasive Surgical Procedures; Osteotomy - economics; Osteotomy - methods; Osteotomy - statistics & numerical data; Patient Acceptance of Health Care; Pneumology; Postoperative Complications - epidemiology; Prostheses and Implants; Retrospective Studies; Severity of Illness Index; Sternum - abnormalities; Sternum - surgery; Surgical Flaps; 5; Corrective surgery; Treatment; Anesthesia; Surgical approach; Circulatory system; Cardiology; Repair; Current; Result
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2004.03.011

Recent publications have advocated a minimally invasive approach to repair of the pectus deformity. Efforts to evaluate this new approach have been hampered by lack of comparative information regarding outcomes of the standard Ravitch approach. We use a modified Ravitch procedure, and present our series as a basis for comparison. Records of 69 consecutive patients undergoing repair of the pectus deformity were retrospectively reviewed. Modifications included a minimal incision and a new technique to address sternal angulation. A patient satisfaction survey evaluated the patients' perception of the outcome. We found one wound infection (1.4%). Five patients (7.2%) had a seroma, and were treated as outpatients. Because the minimally invasive approach is used for pectus excavatum, we divided our series into excavatum and carinatum subsets. The subset of 44 pectus excavatum patients had a mean postoperative length of stay (LOS) of 2.9 days. The median patient satisfaction score was 4 on a scale of 1 to 5, at an average of 4.75 years after repair. The subset of 25 pectus carinatum patients had a mean LOS of 2.4 days and a median patient satisfaction score of 5. The modified Ravitch procedure yields excellent results with low morbidity, hospital LOS, and cost, combined with high patient satisfaction. These current data will be useful for comparison as newer techniques for pectus repair continue to evolve.