Modified sternal elevation for children with pectus excavatum.

OBJECTIVE

To describe our experience in the treatment of pectus excavatum (PE) using a modified sternal elevation procedure.

METHODS

From Oct. 1986 to Dec. 1997, 171 patients with PE were admitted to the Department of Pediatric Surgery of the First Hospital of West China University of Medical Sciences. All patients were diagnosed through a history and physical examination. Cardiopulmonary function was assessed by M-mode echocardiography and instrument of pulmonary function in 40 patients before and 4.2 years after surgery which was performed between 1989 and 1994. We performed the following three procedures in the sternal elevation: (1) forming the metal strut in a "arch" shape, (2) suturing the perichondrium into a "pipe" shape, and (3) encouraging patients to do chest expansion exercise after operation. All patients were followed up for 1 to 12 years.

RESULTS

The normal contour of the costal cage was enlarged in all but one patient. Exercise tolerance was improved, and cardiac function recovered to the same level as in healthy children, while pulmonary function recovered very slowly after surgery.

CONCLUSION

The normal appearance of chest wall can be recovered and normal cardiopulmonary function can be restored by the modified sternal elevation procedure in children with PE.