Clinical experience of Nuss procedure for pectus excavatum in adult female patients

Background: Pectus excavatum (PE) repair by Nuss procedure is well established in pediatrics, but studies of adult female patients are rare. We analyzed the efficacy of the Nuss procedure in adult, female PE patients. Methods: We retrospectively reviewed adult patients who underwent Nuss repair of PE from April 2005 to November 2007. Precise morphologic characterization of the pectus allowed an appropriate shaping of the bars to achieve a symmetric repair. Results: Out of 126 consecutive adult patients who underwent the Nuss procedure at our institution, 15 women with a mean age of 24.6 ± 4.01 years were enrolled in the study. Their preoperative Haller index had a mean of 5.72 ± 2.38. Seven patients (46.67%) underwent repair with the insertion of double pectus bars. Complications included transient bilateral pneumothorax (n = 1) and right-sided pleural effusion (n = 1). One patient received a subsequent breast augmentation, which yielded a better thoracic contour. Conclusions: The Nuss procedure offers a high satisfaction rate and an acceptable complication rate for PE repair in adult female patients. A subsequent surgery for breast augmentation can be considered after the Nuss repair has stabilized.