Radiological changes after Nuss operation for pectus excavatum

Artūras Kilda, Saulius Lukoševičius¹, Vidmantas Barauskas, Živilė Jankauskaitė, Algidas Basevičius¹

Department of Pediatric Surgery, ¹Department of Radiology, Kaunas University of Medicine, Lithuania

Key words: pectus excavatum; Nuss operation; radiological evaluation; postoperative results.

Summary. The objective of this study was to evaluate sternovertebral distance and the chest wall deformation after Nuss procedure.

Materials and methods. Anteroposterior and lateral chest radiographs were performed before Nuss procedure, 1, 6, and 12 months after operation and finally 1 month after bar removal. Sternovertebral distance and transversal chest dimension were measured on radiographs, as well as Haller and vertebral indexes were calculated.

Results. A total of 84 children with funnel chest were operated on. Preoperative sternovertebral distance was 79.81±6.96 mm; 1 month after operation, 97.84±17.08 mm; 6 months, 110.55±13.85 mm; and 12 months, 113.6±14.61 mm. After removal of the bar, the distance was 105±11.95 mm. The mean increase in sternovertebral distance during the first month was 18 mm (P<0.0001); 1–6 months, 12.8 mm (P=0.0006); and 6-12 months, 3 mm (P=0.48). The mean decrease in sternovertebral distance after removal of the bar was 8.6 mm (P=0.47). The decrease in transversal chest dimension during the first month was significant (13.3±12.86 mm, P=0.012).

Conclusions. The sternovertebral distance was significantly increased after Nuss operation. Restoration of deformation proceeds during all the first year after operation. The dynamics of deformation is better depicted by means of vertebral index rather than Haller index.

Correspondence to S. Lukoševičius, Department of Radiology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: slu@delfi.lt, saulius.lukosevicius@kmuk.lt

Received 12 December 2007, accepted 4 September 2009