Pectus Excavatum is the most common congenital thoracic deformity, mostly found at birth, with an incidence of about 0.1%. This congenital deformity is manifested at birth as a sunken anterior chest wall centered on the sternum, shaped like a funnel, and becomes increasingly aggravated with growth and development. Due to the compression of the heart and lungs by the sunken sternum, the development of organs will be hindered, and the symptoms will be aggravated gradually by respiratory infections and reduced activity endurance. It causes great mental burden and psychological stress to the affected children and their parents. Some patients, especially after entering adolescence, may become introverted, have low self-esteem, or even depressed. The etiology of funnel chest is still unknown, but it may be due to the excessive unbalanced growth of rib cartilage. The incidence of funnel chest is 6 times higher than that of pectus excavatum. Funnel chest is not associated with calcium deficiency, and calcium supplementation cannot treat funnel chest. Treatment Surgical correction is the only option to improve the condition. Mild deformities without symptoms are followed up regularly. The disease tends to worsen with growth, especially during the growth spurt, and can change from mild to severe within 6-12 months. Clinical symptoms, severe deformity, or worsening of symptoms during follow-up; chest CT showing: heart and lung compression, CT index R3.25 (CT index is not suitable for funnel chest with predominantly flat chest); recurrent funnel chest, etc. require surgery. According to foreign literature about 20% of patients are operated due to psychological factors. Previous surgical procedures include sternumturnover, rib cartilage resection or severance (Ravitch procedure), which are rarely used due to the high surgical damage, long operation time, poor surgical results, high recurrence rate after surgery, especially the compliance of the chest wall (that is, the elasticity of the chest wall) is significantly reduced. At present, the popular surgical methods include minimally invasive funnel chest correction and ultra-minimally invasive funnel chest correction, which has been improved to address its shortcomings. Minimally invasive funnel chest correction: In 1988, Donald Nuss, an American doctor, in cooperation with Waiter Lorenz Surgical Inc. established a new minimally invasive procedure to correct funnel chest (called NUSS procedure). The advantages are: 1. small trauma: the incision is only 3-4 cm, with little intraoperative bleeding; 2. easy surgery: a steel plate is used to lift the depressed chest wall; 3. good surgical results: the improvement of the chest wall shape is closer to normal compared to previous surgeries; 4. no loss of chest wall compliance, etc.; the chest wall maintains its original elasticity, which is very important for the improvement of lung function. However, NUSS surgery is not perfect, and there are still many areas that need to be improved. Therefore, based on NUSS surgery, ultra-minimally invasive funnel chest correction has been developed. The procedure not only retains the original advantages of NUSS surgery but also overcomes its main disadvantages. 1. Less traumatic: the incision is only 1.5-2.5 cm, less bleeding, no violent flipping of the plate in the body, and even no drops of blood can be seen during the whole procedure. 2. 3. Better surgical results: the design of the steel plate is more reasonable, the stability is better, the surgical effect can be maintained from the beginning to the end, and the steel plate will not restrict the growth and development of the child, and the postoperative thoracic shape is more perfect. 4. Less patient pain: due to the small trauma and good stability of the steel plate, the postoperative pain is lighter and shorter, and the patient can sleep on his side after surgery. The patient does not need to sleep flat on his back for half a year after surgery like NUSS. New understanding of common complications of funnel chest surgery: (1) Plate allergy: Plate allergy is one of the common complications after funnel chest surgery, but we found that the so-called “plate allergy” is closely related to the surgical method and operation, “plate allergy” is mostly caused by the plate However, we found that the so-called “plate allergy” is closely related to the surgical approach and operation. Conventional minimally invasive funnel chest surgery requires the plate to be turned over in the body, so the gap between the chest wall and the plate is larger, and the mobility of the plate is also larger, and the surgical damage is also relatively large, so “plate allergy” will inevitably occur. In contrast, the minimally invasive funnel chest orthopedic steel plate in the body is closely integrated with the chest wall, and the steel plate can not move in the body after fixation, and the surgery itself is less damaged, so complications such as steel plate allergy can almost be avoided. (2) Pain: The generation and degree of pain are related to the patient’s age, sensitivity to pain, the degree of funnel chest depression, the way of surgery, the support part of the plate, the mobility of the plate in the body and other factors. The first three factors are unchangeable, while the last three factors have room for improvement. In particular, the support site of the plate and the mobility of the plate in the body have the greatest influence on postoperative pain. The support point of the plate on the intercostal muscle is less painful than on the rib cage, and the less the mobility of the plate, the less painful it is. In minimally invasive funnel chest surgery, the plate is supported by the rib cage, and the plate does not move at all against the chest wall, so the pain is mild. The feedback from parents after surgery is that the child recovers faster than expected. (3) Displacement of the plate: Displacement of the plate is a common complication after funnel chest surgery. Many patients have good correction effect in the early stage of surgery, but the correction effect becomes more and more unsatisfactory with time, which is caused by the displacement of the steel plate in the body. The displacement of the plate in the body is closely related to the selection of the plate support point (intercostal muscle or rib), the mobility of the plate in the body, the degree of damage to the intercostal muscle, and the width of the plate. The support point of the ultra-minimally invasive funnel chest plate is on the upper and lower ribs adjacent to the plate, so the support area and support force are large and stable and not easy to sink, and the loss of intercostal muscles is small, and the stability of the plate is enhanced by using a wide plate for large children. Exercise for patients with funnel chest Physical and physical training for mild to moderate funnel chest. Objectives: 1 improve cardiopulmonary function; 2 improve body shape: the funnel chest posture can aggravate the funnel chest deformity; 3 increase the volume of the chest cavity; 4 stop the aggravation of the mild deformity; 5 exercise to delay the progression of the moderate to severe deformity, so that the patient has the opportunity to operate at the optimal age (before development). Exercise content Respiratory training: deep breathing several times a day for several minutes each time, or practice blowing up balloons. Physical training: sit or stand in a straight chest posture or participate in dance training, etc. Various aerobic exercises: such as swimming, running, etc. Post-operative exercise starts after 6-8 weeks, the exercise content is the same as above .