Nuss surgery in a 51-year-old patient

V.A. Markushin, R.Ya. Khayaliev, Sh.U.Rakhimy

¹the clinic «Chalet-Sante» (Krasnodar, Russia).

²Multidisciplinary international clinic «Surgemed», Urgench, Uzbekistan

Background and Aim

Pectus excavatum (PE) is the most common congenital chest abnormality, and affects males 5 times more frequently than females. PE results from improper fusion of the ribs with the sternum during embryologic development. The cardinal presenting sign is chest depression. There are limited data on the outcome of Nuss surgery for plastic funnel-shaped chest deformity in adults. For example, Sakamoto Y, et al. (2021) operated on six patients aged 24 to 43 years. After the Nuss operation, the funnel shape of the chest improved in all cases, the thoracic spine of the patients also shifted forward, and the chest shifted forward, and the stoop of the patients decreased. Our goal was to determine the possibility of performing the Nassa operation after 50 years

Method

Patient R.O., 51 years old, male, chest changes have been noted since birth. He was operated on as a teenager in a hospital at his place of residence, Ravich’s operation was performed with an attempt to correct PE, however, a relapse occurred quite quickly in the postoperative period. In December 2022, an ulcer of the duodenum was detected, treatment was carried out under the supervision of a gastroenterologist under EFGDS control. Continues receiving treatment recommended by a gastroenterologist.

Results

In the early postoperative period, 13 (5.2%) patients had complications: pleurisy – 7 (2.8%), wound suppuration – 1 (0.4%), periimplantitis – 1 (0.4%), postoperative pneumonia – 3 (1.2%), plate detachment with displacement in 1 (0.4%) patient, in the latter case, a second operation was needed. No fatal cases were noted. Good results were observed in 237 (94.8%) patients. It should be noted that pleurisy is noted in 5% of patients older than 30 years.