Wang technique: a novel minimally invasive surgical fixation technique for the treatment of pectus excavatum.

BACKGROUND

Pectus excavatum (PE) is the most common thoracic deformity. Currently, the modified Nuss procedure with steel bar implantation is the primary surgical treatment for PE. Traditionally, the bar is fixed using a stabilizer; however, this method is relatively complex and associated with complications. We designed a novel minimally invasive surgical fixation technique (the Wang technique) for the treatment of PE. This study assessed its efficacy and technical characteristics to provide valuable insights into the surgical treatment of PE.

METHODS

The clinical data of patients with moderate to severe PE who underwent the modified Nuss procedure with two bars in the Department of Chest Wall Surgery at our hospital between January 2018 and December 2022 were retrospectively analyzed. The data collected included the patients' medical history, severity of PE, imaging findings, operative details, application of the Wang technique, bar retention time, and postoperative complications (e.g., wire breakage and bar displacement). The variables were analyzed to assess the characteristics of the Wang technique.

RESULTS

A total of 343 patients were enrolled in this study (299 males and 44 females), including 32 with moderate, 220 with severe, and 91 with extremely severe PE. The Wang technique was used for bar fixation during the surgery. The operative time ranged from 25 to 100 (48.95±15.07) min, and the intraoperative blood loss ranged from 1 to 50 (7.20±5.96) mL. All patients were followed up until bar removal. The bar retention time ranged from 11 to 73 (34.72±6.82) months. Five bars showed displacement (0.73%), occurring in four cases (1.17%), all of which were axial. Additionally, 17 fixation wires were found to be broken (1.00%). All patients were discharged after the successful removal of the bars and fixation wires. No PE recurrence was observed.

CONCLUSIONS

The Wang technique is effective for the treatment of PE, with a low incidence of bar displacement. It has potential for broader clinical application.