PURPOSE: Pectus excavatum is a challenging clinical problem in the adult or adolescent patient due to the more rigid thoracic wall and advanced body self image. Long-term results of the sternal eversion technique are not currently described.
METHODS: A retrospective analysis was conducted of all patients over the age of 12 undergoing sternal eversion for pectus excavatum at LDS Hospital. Records were reviewed for concomitant procedures and postoperative complications. Patients were directly contacted to obtain follow-up on exercise tolerance and cosmetic result.
RESULTS: Fourty-four adolescent and adult patients underwent sternal eversion for pectus excavatum over a 21-year period from 1984 to 2005. Mean age was 21.4 years (range 13-67); there were 31 men and 13 women. Mean follow-up was 6.7 years (range 1 month to 19 years). Two patients had concomitant cardiac surgery, 5 had prior pectus repair, and 29 had bilateral pectoralis major flaps. Five (11.4%) patients were lost to follow-up and 3 (6.8%) declined follow-up. Of the remaining 36 patients, 30 (83%) described their postoperative general health as much better or somewhat better than before surgery. Twenty-six (72%) had no or very little limitation of vigorous activity and all 36 (100%) had no limitation of moderate activity. Thirty-one (86%) described their cosmetic appearance after surgery as excellent or very good.
CONCLUSION: Sternal eversion offers excellent long-term results for correction of pectus excavatum in adolescents and adults. The majority of patients have little, if any, limitation in physical activity and are satisfied with the cosmetic result of this technique.
CLINICAL IMPLICATIONS: Sternal eversion provides a durable cure for pectus excavatum in the adult and older adolescent. The operation is safe and effective for even severe forms of this chest wall deformity.
DISCLOSURE: John Doty, None.