Single-incision modified Nuss procedure compared to non-flipping bar in pediatric pectus excavatum patients.
This single-center retrospective cohort study included 171 pediatric and adolescent patients with pectus excavatum treated at Shanghai Children's Hospital. The population was divided into two groups: 140 patients underwent a single-incision modified Nuss procedure, while 31 patients received a modified Nuss procedure with a non-flipping bar. The primary outcome assessed was therapeutic efficacy, with secondary outcomes including operative time, number of incisions, screw fixation rate, Haller index, overall complication rates, and postoperative recovery indicators.
Results indicated that the non-flipping bar group had a longer median operative time and a higher number of incisions compared to the single-incision group. Additionally, the non-flipping bar group demonstrated a lower screw fixation rate and a higher median Haller index. However, there were no significant differences observed between the two groups regarding overall complication rates or postoperative recovery indicators. After propensity score matching, no statistical difference was found between the groups concerning surgical efficacy.
Safety and tolerability data were not reported for adverse events, serious adverse events, discontinuations, or general tolerability in this study. The follow-up period was described as short to intermediate-term. The study authors note that surgical selection should be tailored to patient age and deformity characteristics. Limitations inherent to the retrospective design and the single-center setting were not explicitly detailed beyond the study type classification.
The practice relevance suggests that clinicians should consider patient-specific factors such as age and the specific characteristics of the chest wall deformity when selecting between these surgical options. The evidence does not support a definitive superiority of one technique over the other for all patients based on efficacy or safety profiles in this specific cohort.
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