Pectus Excavatum. What is it? How is it treated?
What is pectus excavatum? When is surgery necessary? And what is a Nuss procedure? In this
video, you will find the answer to these questions. You or your child may have pectus excavatum. Our team at Nicklaus Children's Hospital is here to answer your questions and guide you through the treatment process. In this video series called “ When You Have Pectus Excavatum,” we will answer most common questions and provide you with information on how to prepare for a Nuss procedure.
Pectus excavatum Is an inherited condition in which a person's breastbone is sunken into the
chest. Often, it is a slight indentation in the chest that is noticeable shortly after birth. This is a
progressive condition, meaning that it typically worsens during the adolescent growth spurt and
it may continue to worsen during adulthood. This condition is more common in boys than in
girls, with a 4-to-1 male predominance, affecting more Caucasians.
Pectus excavatum occurs when there is excessive growth of the connective tissue (cartilage)
that joins the ribs to the breastbone. The exact cause of pectus excavatum is not known, but it
has a genetic component, as 40% of those affected have a family member with the same
condition. Pectus excavatum is the most common malformation of the chest wall and occurs in
approximately 1 of every 400 to 1,000 births.
Pectus excavatum can make children feel self-conscious about their appearance, even for mild
cases. This disorder can restrict the growth of the vital chest organs. Symptoms of this disorder
may include chest pain, heart palpitations, respiratory symptoms , and exercise intolerance.
At Nicklaus Children’s Chest Wall Deformity Center, patients are evaluated, counseled, and
treated by our multidisciplinary clinical team. Some children with pectus excavatum report that
they have chest pain and shortness of breath or limited stamina with exercise. Other children
have no symptoms. Options are reviewed and a course of treatment is selected with input from
the family, based on the severity and asymmetry of the defect.
Our pediatric surgical team has applied an innovative surgical treatment to correct this
condition, with numerous benefits to young patients. Using the minimally invasive Nuss
procedure children usually can return to their normal activities in about a month.
The Nuss procedure involves a concave stainless-steel bar that is slipped under the sternum
with the assistance of a scope (small camera) using two small incisions on each side of the
chest. The bar is then flipped, and the sternum moves to the proper position.
The procedure is done under general anesthesia and takes about two hours. The in-hospital
recovery time is relatively short. Pain is common after a Nuss procedure. Therefore, the patient
may remain at the hospital for one to three days for effective pain management.
Based on surgeon preference, cryoablation maybe used during your child's operation. This
technique uses a special freezing method to temporarily block pain signals from nerves in the
affected area. This achieves an effect similar to a local anesthetic. It has been showed that
Cryoablation helps minimize pain following repair of pectus excavatum. Additionally, the
implementation of cryoablation has shortened hospital stay and reduced the need for opioid
analgesia. The surgical preparation and operation are the same with or without cryoablation.
The next video of this series will provide you with information on what to expect the day of the
surgery. Here at Nicklaus Children's Hospital, we want to create a healthy future for our
children.
22 авг 2024
