The factors determining the complications in the minimally invasive surgical correction of pectus excavatum

Background: In this study, we determined the factors determining the complications in the minimally invasive correction of pectus excavatum. Methods: Two hundred and eleven consecutive patients (187 males, 24 females; mean age 17.7 years; range 5 to 45 years) who had undergone minimally invasive intervention for the repair of pectus excavatum in our clinic between June 2006 and November 2010 were restrospectively evaluated. The preoperative clinical data, surgical findings, and postoperative complications of all patients were recorded. Results: Thirty-eight complications (18%) developed in a total of 34 (16.1%) patients. The most common complications were bar shift or rotation requiring reoperation (n=13; 1.6%). When the complications that developed in the patients were evaluated with univariate analysis, male gender, multiple bar implantation (p=0.001) and age over 20 years were found as risk factors. However, in the multivariate analysis, only age over 20 years was found to increase the risk of complications (p=0.18). The mean duration of postprocedural hospitalization was 4.74 (range 2 to 21) days. Conclusion: In the minimally invasive correction of pectus excavatum, differently from the classical method, the long-term aesthetic result is excellent as there is no need for pectoral muscle flap lifting, cartilage resection or sternal osteotomy. The procedure may also be performed in adult patients. The rate of postoperative complications in male patients over the age of 20 is slightly higher but acceptable.