Funnel chest correction is minimally invasive and safe with good results

  Funnel chest is the most common pediatric chest wall deformity, which refers to the depression of the anterior chest wall centered on the sternocleidomastoid, including the sunken lower sternum and the backward bending of the rib cartilage on both sides, making the entire depressed area shaped like a funnel and giving it its name. The cause is still unclear, mostly due to congenital developmental abnormalities, and 10%-20% of children have a family history. The incidence rate is reported to be between 1 and 2 per 1,000 in foreign countries, but there are no exact statistics in China, but from the relevant data, there are scattered incidences all over China, more males than females, generally 4:1, and it is a dominant genetic trait. In severe cases, the physiologically sunken thoracic ribs can compress the heart, lungs and other thoracic viscera, causing a series of clinical manifestations such as panic, shortness of breath, dyspnea, pain in the anterior thoracic region, and recurrent respiratory infections. Children often have reduced exercise tolerance, and older patients are generally reluctant to participate in sports activities, and are introverted and have psychological disorders such as lack of self-confidence, depression, excessive shyness, and even suicidal tendencies.  The treatment of funnel chest has a history of 100 years. The most commonly used thoracic rib lift (including the Ravitch method) has two major defects: first, the surgery is very traumatic, the pleura is easy to break, the intramammary vessels are damaged, and postoperative abnormal breathing and pulmonary complications often occur; second, the orthopedic effect is mostly unsatisfactory, sometimes forming a sternal protrusion deformity, which does not completely achieve the patient’s aesthetic requirements. In 1997, Dr. NUSS first reported the minimally invasive correction of funnel chest, and after years of improvement and practical application, it has now become the main surgical method for funnel chest correction. Compared with traditional sternal reversal and rib lift, the advantages of NUSS minimally invasive funnel chest orthopedic surgery are: 1, no need to make an incision in the anterior chest wall to lift the pectoralis muscle skin piece, no need to cut and remove the rib cartilage, and no need to perform sternotomy, which minimizes the damage to the patient; 2, the operation time is significantly shortened; 3, in line with the physiological and anatomical characteristics; 4, the orthopedic plate is fixed and stable, and the efficacy is exact. 5.Early recovery time, short hospitalization period, less application of antibiotics, and low cost of medicine; 6.No incision in the anterior chest, and beautiful appearance.  In recent years, the thoracic surgery department of Daping Hospital was the first to introduce and successfully carry out “NUSS minimally invasive funnel chest orthopedic surgery” in China. The patient’s age is mostly chosen from 3 to 23 years old, and the operation is performed by making an incision of about 2cm on both sides of the chest wall, and fixing the special orthopedic plate behind the sternum under the guidance of thoracoscope or blind vision along the posterior mediastinal space of the sternum. After long-term post-operative follow-up, the patient’s orthopedic effect was stable and restored the normal thoracic shape, which was well received by the treated patients and their families. This surgical technique has been fully matured in the Department of Thoracic Surgery of Daping Hospital, making it one of the few medical units in China with this technique.