Abstract
The technique for minimally invasive repair of pectus excavatum (MIRPE) has been adopted
by most surgeons as the preferred method for treatment of this condition. However,
there is limited awareness about the complications related to the procedure. Most
importantly, the prevalence and potential for life-threatening complications have
frequently been underestimated. The purpose of this communication is to increase awareness
of the risk of minor and major (life-threatening) complications, as well as the operative
steps and modifications which have been developed to prevent them. One of the most
common complications reported in the early series of MIRPE cases was bar displacement,
frequently requiring reoperation. Fortunately, technical modifications to the technique
have resulted in a decrease in the incidence of such events from 10 to less than 2%.
It is important for surgeons to have a good understanding of the potential complications,
particularly the major type of complications post-MIRPE and postpectus bar removal.
Although rare, the risk of mortality is real and it is the surgeon's responsibility
to ensure optimal patient safety when performing this procedure. Factors such as operative
technique, patient age, pectus severity and asymmetry, previous chest surgery, and
the surgeon's experience play a role in the overall incidence of adverse events. These
preventable events can be avoided with proper training, mentoring, and careful patient
selection.
Keywords
pectus excavatum - mortality - morbidity - life-threatening complications - minimally
invasive repair - Nuss procedure - cardiac injury - pectus bar removal - chest wall
- deformity
