Abstract
Background Pectus excavatum deformities are usually repaired with a minimally invasive approach
in which a metal bar is used to correct the chest wall abnormality. We aimed to evaluate
long-term outcomes and patient satisfaction after surgical correction.
Methods Patients who underwent pectus excavatum repair and subsequent bar removal at a single
tertiary care center from January 2000 to December 2020 were identified. A retrospective
chart review was performed, and a telephone survey was conducted to evaluate perceived
inward chest movement, need for surgeon reevaluation, surgical reintervention, and
overall satisfaction. Data are presented as medians with interquartile ranges (IQRs)
and frequencies with percentages.
Results A total of 583 patients were included. The survey response rate was 26.2% (n = 153). The respondents were predominantly male (80.4%, n = 123) with a median age at surgical correction of 14.9 years (IQR 12.9, 16.1) and
a median Haller index (HI) of 3.8 (IQR 3.4, 4.5). Median time to bar removal was 2.9
years (IQR 2.5, 3.0) with a median age at removal of 17.7 years (IQR 15.5, 19.0).
Median time from surgery to survey follow-up was 9.6 years (IRQ 5.0, 11.4) with respondents
having a median age at follow-up of 25 years (IQR 22.0, 28.4). The satisfaction rate
was 96.7% (n = 148) with a reintervention rate of 2.0% (n = 3). The perceived inward chest movement was 30.7% (n = 47) with 12.8% (n = 6) of those requesting surgical reevaluation.
Conclusion There is a high level of satisfaction many years after correction of pectus excavatum
and bar removal. With the advent of cryoablative therapy since 2017, patient satisfaction
improved by experience of less postoperative pain. Reintervention rate is low despite
some patients reporting a perceived chest wall inward movement.
Keywords
pectus excavatum - outcomes - satisfaction - recurrence - chest wall
