The Institute of Chest Wall Surgery
Pectus Excavatum
Introduction
Pectus excavatum is a common congenital chest wall deformity, characterized by an inward depression of the lower and middle parts of the sternum and its adjacent ribs, forming a funnel-like shape. The deepest part of the depression typically resides superior to the xiphoid process.
Causes
The exact cause of pectus excavatum remains unclear, but the genetic factor is believed to be involved. Additionally, delayed development of the diaphragm behind the sternum during embryonic growth, or excessively rapid growth of the costal cartilage below the sternum, might also exert a pulling force on the sternum, ultimately leading to an indentation of the anterior chest wall.
Symptoms
Mild pectus excavatum typically does not lead to serious health issues or symptoms. However, in severe cases, the indented chest wall can compress the heart and lungs, causing symptoms like palpitations, shortness of breath, and breathing difficulty. Additionally, patients may experience a loss of appetite, indigestion, delayed growth, frequent upper respiratory infection, and increased psychological stress.
Meanwhile, pectus excavatum can also lead to scoliosis, a condition that is more common in patients with severe deformity or those who have had the condition for many years.
Diagnostic Methods
Diagnosis involves assessing the patient’s clinical manifestations and physical signs, along with imaging examinations such as X-ray, chest CT scan, and electrocardiogram.
Surgical Procedures
This new generation of minimally invasive procedure is specifically designed for pectus excavatum, with operating principle and surgical steps entirely different from traditional procedures like the Ravitch procedure and the Nuss procedure. This innovative procedure offers several key advantages, including minimized trauma, a shorter recovery period, and most importantly, effective prevention of heart damage. It is particularly suitable for young patients under the age of 5, and the surgical results are more stable and long-lasting.
This new surgical method was developed to improve the defects of the Nuss procedure. While both procedures are based on similar fundamental operative principle, the Wung procedure incorporates numerous innovations and optimizations at every step, including safer and simpler bar placement and fixation techniques. These innovations not only substantially enhance the safety, reliability, and effectiveness of surgery but also greatly reduce the incidence of complications and shorten the patients' postoperative recovery period.
