• Daniel C Aronson, Remko P Bosgraaf, Eva-Maria Merz, Reindert P van Steenwijk, Wim M C van Aalderen, and Robertine van Baren.
• Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU Medical Center, PO Box 22700, 1100 DE, Amsterdam, The Netherlands. d.c.aronson@amc.uva.nl
• World J Surg. 2007 Jul 1; 31 (7): 1518-22.

BackgroundThe Nuss procedure was introduced at our center in 1999. The operation was mainly performed for cosmesis. Little information is available regarding the influence of this operation on lung function.MethodsThe aim of this study, a prospective analysis, was to analyze the effect of the Nuss procedure on lung function variables. Between 1999 and 2007 a total of 203 patients with pectus excavatum were treated with the Nuss procedure, of whom 145 (104 male, 41 female) were located at Emma Children's Hospital. In the latter subset of consecutive patients, static lung function variables [total lung capacity (TLC), functional residual capacity (FRC), vital capacity (VC)] and dynamic lung function variables [forced expired volume in 1 s (FEV(1)), maximum expiratory flow (MEF(50))] were performed using spirometry and body box measurements at four time points: prior to operation (T0), 6 months after the Nuss procedure (T1, n = 111), prior to removal of the Nuss bar (T2, n = 74), and 6 months after removal (T3, n = 53). All values were expressed as a percent of normal values for sex, age, and height. Results were compared with a paired-samples t-test, with the level of significance at p = 0.05.ResultsAt 6 months after bar insertion the TLC, FRC, VC, FEV(1), and MEF(50) showed a significant increase; and prior to bar removal the FRC and MEF(50) showed significantly increased values. At 6 months after Nuss bar removal, none of the lung function variables showed any significant change compared to the preoperative values.ConclusionAfter the Nuss procedure for pectus excavatum, there was no improvement of pulmonary function, but neither was the patient's pulmonary function harmed by resolving a largely cosmetic problem.

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