Treatment features-minimally invasive treatment of funnel chest

    Funnel chest is a common congenital developmental anomaly in children, mainly referring to the thoracic deformity caused by the backward depression of the sternum during growth and development, which is medically called “funnel chest” because of its shape like a funnel-shaped “pit.  The backward depression of the sternum in children with funnel chest causes compression of the heart and lungs, resulting in poorer lung capacity than their peers, easier respiratory tract infections, and poor exercise tolerance, which seriously affects growth and development. Due to the deformity, these children are often ashamed to expose their foreheads in public, afraid to wear tank tops in summer, afraid to take baths and swim in public bathrooms, and the children and their parents are under a lot of mental burden and psychological pressure, and some of them even form withdrawn personalities, therefore, timely and effective correction of the deformity is essential to improve the growth and development of the children and dispel the psychological haze.  The traditional treatment method of funnel chest is to cut the skin longitudinally in the anterior chest of the child, the incision is about 15-20 cm long, the pectoral muscles on both sides are separated, the sternum is cut off and some ribs on both sides are removed, then the sternum is turned over and fixed with steel pins, the truncated rib cartilage is sewn on with threads, then the muscles are covered and the incision is sutured. This method is very traumatic, bleeding, long (about 2.5-3 hours), and slow to recover after surgery. The needles are easily moved, often displaced, bent, or even broken, and leave permanent scars after surgery.  At present, this type of surgery is less used internationally. The most advanced minimally invasive funnel chest orthopedic surgery, the Nuss procedure, was first invented by Dr. Donald Nuss, a famous American surgeon, in 1998 and soon became popular worldwide, also known as the revolution in chest wall deformity surgery. The procedure requires only a 2-4 cm incision on both sides of the chest wall and another 1.5 cm incision on the right side of the chest wall, where a thoracoscope is inserted and the plate is delivered to the back of the sternum under its supervision. This method is less traumatic, does not cut the ribs, less bleeding (5-10 ml), the operation time is only 30-40 minutes, the postoperative recovery is fast, the plate is firmly fixed, there is no incision in the anterior chest, the appearance is beautiful, and it is the internationally accepted operation method. At present, our thoracic surgery department is the first to carry out successfully in the city.  Experts in thoracic surgery suggest that younger children with mild funnel chest have little effect on respiratory circulation and do not need to be treated urgently, as they may correct themselves with growth and development. For children with moderate and severe funnel chest, surgery is recommended to correct the deformity, and the best age for surgery is 6-12 years old. Surgery significantly improves the appearance of the child’s chest, relieves the compression of the heart and lungs by the sunken sternum, improves the child’s tolerance and mobility, reduces respiratory infections, and relieves the child’s psychological stress, allowing him/her to grow up healthy and happy.