[Repair for anterior chest wall deformity by Nuss procedure performed in young adults and older adolescents].

Results of 86 minimally invasive anterior chest wall reconstructions for pectus excavatum by the method of Nuss are evaluated retrospectively. Complications, possible ways of avoiding those and technical details of the operation are discussed. Nuss method is also evaluated in terms of suitability patients' age. Minimally invasive anterior chest wall reconstructions were performed in 86 patients in the last seven years. The average age was 21.4 years. There were no severe intra-operative complications. Four dislocations of the metal bar (12 and 53 days after chest reconstruction) were observed and treated by Nuss-technique. One metal bar had to be removed on the 13th postoperative day for local septic complication, and another one for significant sterile dislocation 14 months after the operation. One patient asked for removal of the metal bar because of pain. In one case bleeding from a small side-branch of the internal mammary artery was stopped by VATS technique, a small superficial lung injury was treated by thoracic drainage. Over 90 percent of patients were satisfied with the cosmetic results. Operating time and length of hospital stay gradually decreased throughout the years. Nuss technique can be performed safely in young adults for pectus excavatum with excellent long-term results. Less pain and shorter operating time of minimally invasive repair are the advantages of the procedure. Age above 30 years and previous open chest correction increases the risk for operation.