The changing trend in surgical reconstruction of pectus excavatum.

The purpose of this presentation is to review our experience in the correction of pectus excavatum deformity over the past 25 years, to draw attention to some details of importance in securing an excellent end result, and to describe a slight technical modification which improves the cosmetic effect of the surgical procedure. Seventy-five operations were performed between 1951 and 1975 at the North Middlesex Hospital, Regional Cardiothoracic Centre, Edmonton, London, according to the various techniques known during that period. Results were variable until the introduction, 10 years ago, of an operation combining extensive resection of costal-cartilages (34, 35) and stabilization of the sternum (2, 3). Of 37 operations performed during the last 10 years, 35 have given excellent long-term results. The cosmetic results in our hands have been achieved by the use of a stainless steel plate passed beneath the sternum and left in situ for not more than 6 months.