Mode
Text Size
Log in / Sign up

Single-incision modified Nuss procedure compared to non-flipping bar in pediatric pectus excavatum patientsTwo Chest Surgeries for Kids Show Equal Results

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider tailoring surgical selection for pectus excavatum to patient age and deformity characteristics based on this retrospective cohort.

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.

Why Families Seek Answers Now

Many families feel stuck when choosing a surgeon. They fear one method might leave a bigger scar or take longer to heal. This uncertainty makes every decision feel heavy.

For years, doctors debated which technique was better. Some believed fewer cuts meant faster recovery. Others thought a pre-shaped bar was safer for the heart.

The Surprising Shift in Data

But here is the twist. A new study shows both methods work just as well. Neither one wins the race for safety or results.

Think of the chest like a tent frame that got bent. The surgery puts a metal bar inside to push it back out. This bar stays there until the bones harden in the new shape.

How the Surgery Fixes the Shape

One method uses one small cut to slide the bar in. The other uses a bar that is already bent to fit. It is like choosing between a straight stick or a curved one.

Researchers looked at 171 kids at a hospital in Shanghai. They tracked patients from 2015 through 2022. The goal was to see which method worked best in real life.

What the Numbers Tell Us

Both groups had similar recovery times and pain levels. Complication rates were low for everyone involved. The final look of the chest was good in both cases.

Doctors measured the chest depth to check the fix. Both groups improved equally well. The group with the pre-shaped bar took a bit longer in the operating room.

They also needed more small cuts to hold the bar in place. However, the difference did not change the outcome.

This doesn’t mean this treatment is available yet.

Surgeons say the choice depends on the child’s age. A younger child might need a different approach than a teenager. The shape of the chest also guides the decision.

Families should talk to their surgeon about these options. Do not assume one way is better without asking. Your doctor knows your child’s specific needs best.

This study looked at records from one hospital only. It did not follow patients for many years after surgery. More data is needed to confirm these findings.

Doctors call this a review of past records. It is not a new experiment.

Doctors will keep watching patients to see long-term results. Approval for these methods is already in place. The focus now is on matching the right method to the right child.

New trials will start to check long-term safety. This ensures the best care for future patients.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
ObjectiveThis study aimed to compare the clinical utility of two modified Nuss procedures in children and adolescents with pectus excavatum (PE), including single-incision modified Nuss and modified Nuss with non-flipping bar. It sought to delineate patient selection patterns, assess perioperative parameters, postoperative recovery, complication rates, and short/intermediate-term efficacy of the two approaches, thereby providing evidence-based guidance for individualized surgical selection.MethodsA single-center retrospective cohort study was conducted on pediatric and adolescent PE patients who underwent surgical correction at Shanghai Children's Hospital between January 2015 and December 2022. Patients were categorized by the intended operative strategy: single-incision modified Nuss (single working incision with optional thoracoscopy through the same incision) versus modified Nuss with a pre-shaped non-flipping bar (advanced without intraoperative 180° turnover). A total of 171 patients were included (140 single-incision; 31 non-flipping bar). Demographic data, clinical characteristics, surgical parameters, and postoperative outcomes were collected.ResultsRegarding surgical parameters, the non-flipping bar group had longer median operative time, more incisions, and lower screw fixation rate. Postoperatively, the non-flipping bar group showed a higher median Haller index, but this difference had limited clinical significance. No significant differences were noted in overall complication rates, postoperative recovery indicators, or surgical efficacy. After PSM, no statistical difference in therapeutic efficacy was found between the two groups.ConclusionBoth the single-incision modified Nuss procedure and the modified Nuss procedure with non-flipping bar are effective and safe for PE in children and adolescents, with comparable therapeutic efficacy. Surgical selection should be tailored to patient age and deformity characteristics.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.