Minimally Invasive Repair of Pectus Excavatum: Analyzing Contemporary Practice in 50 ACS NSQIP-pediatric Institutions

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2015 Mar 28

PMID 25814003

Citations 11

Authors

Maria G Sacco-Casamassima

Seth D Goldstein

Colin D Gause

Omar Karim

Maria Michailidou

Dylan Stewart

Paul M Colombani

Fizan Abdullah

Affiliations

Soon will be listed here.

Abstract

Background: Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown.

Study Design: The American College of Surgeons 2012 National Surgical Quality Improvement Program-Pediatric (NSQIP-P) participant user file was utilized to identify patients who underwent MIRPE at 50 participant institutions. Outcomes of interest were overall 30-day morbidity, hospital readmission, and reoperation.

Results: Chest wall repair designated MIRPE accounted for 0.6% (n = 264) of all surgical cases included in the NSQIP-P database in 2012. The median age at surgical repair was 15.2 years. Thoracoscopy was used in 83.7% of cases. No mediastinal injuries or perioperative blood transfusions were identified. The 30-day readmission rate was 3.8%. Three patients (1.1%) required re-operation due to the following complications: superficial site infection, bar displacement and pneumothorax. The overall morbidity was 3.8% with no incidences of mortality.

Conclusions: This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.

Citing Articles

Perioperative outcomes of thoracoscopic versus non-thoracoscopic minimally invasive repair of pectus excavatum: a systematic review and meta-analysis.

Sun H, Huang Y, Han Y, Lin F J Cardiothorac Surg. 2024; 19(1):603.

PMID: 39396001 PMC: 11470680. DOI: 10.1186/s13019-024-03016-y.

Evolution in the management of pectus excavatum in pediatric patients.

Haecker F Transl Pediatr. 2023; 12(8):1450-1453.

PMID: 37692546 PMC: 10485642. DOI: 10.21037/tp-23-264.

Single Incision non-thoracoscopic Nuss procedure for children with pectus excavatum: protocol for a multicenter, non-masked, randomized controlled trial.

Wang Q, Pan Z, Wu C, Li Y, Wang G, Dai J Front Surg. 2023; 10:1210452.

PMID: 37538392 PMC: 10394465. DOI: 10.3389/fsurg.2023.1210452.

Efficacy and determinants of vacuum bell treatment in preschool children with pectus excavatum.

Luo D, Cheng K, Yuan M, Xu C, He T Front Pediatr. 2022; 10:1008437.

PMID: 36313864 PMC: 9607926. DOI: 10.3389/fped.2022.1008437.

Current Development of Minimally Invasive Repair of Pectus Excavatum (MIRPE).

Haecker F, Krebs T, Kleitsch K Children (Basel). 2022; 9(4).

PMID: 35455522 PMC: 9024707. DOI: 10.3390/children9040478.

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