Complications associated with the Nuss procedure: continued evolution of the learning curve

American Journal of Surgery
Ravindra K VeguntaRichard H Pearl

Abstract

We report unusual and/or significant complications encountered during and after the Nuss Procedure for pectus excavatum. This was a retrospective review that was approved by the institutional review board, with parental consent. Seven patients had unique and/or significant complications as follows: (1) laceration of an internal mammary artery during bar placement requiring emergent minithoracotomy; (2) hemopericardium 10 weeks postoperatively after blunt chest trauma requiring exploration of the pericardium and clot evacuation; (3) almost complete recurrence of the pectus excavatum deformity immediately after bar removal; (4 and 5) immediate/early postoperative bar displacement requiring re-operation and placement of 2 bars each; and (6 and 7) almost complete neo-ossification of the Nuss bar, making removal challenging. The Nuss procedure has met with near-universal acceptance. Complications are just being reported. We describe 7 events to add to the evolving literature as the entire pediatric surgery community participates in the initial learning curve.

References

Jan 17, 2004·The Annals of Thoracic Surgery·Hyung Joo ParkKihl Roh Lee
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Citations

Dec 2, 2010·International Orthopaedics·Mirko Žganjer, Vlasta Žganjer
Jun 10, 2011·Pediatric Surgery International·Chieh-Wen LinChih-Chun Chu
Aug 9, 2011·World Journal of Pediatrics : WJP·Qiang ShuJian-Gen Yu
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Nov 4, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Shu-Li LiuHua-Wei Xie
Feb 11, 2014·Journal of Cardiothoracic Surgery·William Rainey JohnsonSunil Singhal
Aug 6, 2014·Journal of Pediatric Surgery·L E McMahonD M Notrica
Dec 12, 2012·Journal of Pediatric Surgery·Lynnette MazurP Syamasundar Rao
Mar 20, 2012·Journal of Pediatric Surgery·Lisa ObertRichard Azizkhan
Jul 29, 2009·Journal of Pediatric Surgery·Tetsuya IshimaruTadashi Iwanaka
Feb 16, 2013·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Yi-Ling ChenYeung-Leung Cheng
Aug 13, 2011·Contact Dermatitis·Savina AnejaJohn DiFiore
Oct 27, 2009·The Annals of Thoracic Surgery·Theresa D LuuDaniel L Miller
Apr 2, 2014·Interactive Cardiovascular and Thoracic Surgery·Kemal KülcüMohamed A Soliman Hamad
Apr 10, 2012·Orthopaedics & Traumatology, Surgery & Research : OTSR·A WurtzR Nevière
Feb 23, 2013·Asian Cardiovascular & Thoracic Annals·Tiziano De GiacomoFederico Venuta
Jun 21, 2019·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Joseph R EsparazCharles J Aprahamian

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