pectus Excavatum

Pectus excavatum is a malformation of the anterior wall of the chest in which the sternum is inserted into the chest wall. We do not know the cause but it seems that in the growth of these people, who are usually children or adolescents, the costal cartilages cause this deformity to develop in its disorderly growth.

What people should be treated for this condition?

The people who consult for the pectus excavatum are usually, as I said, children or adolescents who have a basically aesthetic problem. No matter how pronounced the pectus excavatum is, its respiratory or cardiac capacity is not diminished, so only the people to whom this defect causes a dysfunction in their social, work, etc. activity should be treated.. Sometimes they are boys or girls who do not want to go to the pool, or who do not want to change with their friends so as not to show their defect.

The treatment of pectus excavatum can be conservative or surgical. The conservative treatment consists of the application of a vacuum chamber with which we raise the sternum during the time it is being applied. We need 1 to 2 years for this sternum to be maintained in a correct way. When this is not enough we use the surgical treatment that can consist of the classic treatment, which is the so-called Rabitch technique, with which we remove the costal cartilages that are causing this sternum to remain defective. This is a technique that is currently performed very rarely because we now have what we call minimally invasive surgery. This minimally invasive surgical technique is called the Nuss technique and consists in introducing a substernal bar, below the sternum, which elevates the same. This bar should be kept for 2 or 3 years and then extracted. The success of this treatment is 95% and we are reaching a step that would be a traction of the sternum without entering the thorax, a novel treatment that we believe will have very good acceptance by patients.