Comparison of the early results of Nuss and modified Ravitch operation techniques in pectus excavatum repair

Background: The aim of this study was to compare the early results of Nuss and modified Ravitch techniques in pectus excavatum (PE) repair. Methods: We retrospectively evaluated 24 patients with PE (18 males, 6 females; mean age 11.4 years; range 5 to 24 years) in whom modified Ravitch technique was performed between March 2004 and June 2006, and 26 patients with PE (17 males, 9 females; mean age 13.3 years; range 2.5 to 36 years) in whom Nuss technique was performed between June 2006 and November 2008. Mean operation time was 40 minutes (range 28-56 minutes) in Nuss group and it was 165 minutes (range 125-240 minutes) in Ravitch group. Results: Patient satisfaction in the postoperative period was evaluated. In the Nuss group, the results were excellent in 24 patients (92.3%) and satisfactory in two patients (7.7%). Pneumothorax was seen in two patients (7.7%) in this group. One patient had self-resolving pneumothorax. In one patient recurrence developed after Ravitch technique was used, he underwent Nuss procedure and 20% pneumothorax occurred, so a tube thoracostomy (3.8%) was done. In one patient an absorbable stabilizer was broken one month after the operation and it was replaced with a nonabsorbable one. Mean hospital stay was 4.7 days (range 4-6 days) in the Nuss group and it was 6.3 days (range 5-8 days) in modified Ravitch group. Conclusion: Long and anterior Ravitch incisions can cause unpleasant esthetic results. Conversely, laterally localized small incisions, shorter operation time and very low blood loss are the important advantages of the Nuss procedure. Nuss technique is a less invasive surgical approach that decreases the hospital stay with low complication rates and provides high patient satisfaction with excellent results.