Pectus excavatum in prepubertal patients can be corrected with optimal long-term results using a minimally invasive procedure, according to authors who performed 42 operations over 10 years.

The authors inserted a convex steel bar under the sternum through small lateral thoracic incisions. The bar was inserted with the convexity facing posteriorly. When in position, the bar was turned over, raising the sternum and anterior chest wall into the desired position.

Patients, who ranged in age from 15 months to 15 years, stayed in the hospital an average of 4.3 days. They resumed regular activity when fully recovered, usually after 30 days.

The bar was left in place for at least two years until the chest configuration became permanent. It then was removed in an outpatient procedure.

Twenty-two of 30 patients who had the bar removed showed excellent results; four had good results; two had fair results; and two had poor results.

Complications included pneumothorax in four patients, skin irritation in four, bar displacement in two, wound infection in one and viral pneumonia in one.

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