Pectus Excavatum Repair
What is Pectus Excavatum Repair ?
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Why do you need Pectus Excavatum Repair ?
Pectus excavatum is the most common chest wall deformity, affecting 1 in 300–1,000 individuals, more frequently in males. While mild cases may be asymptomatic, moderate to severe cases can cause:
- Physical symptoms: Shortness of breath, chest pain, or reduced exercise tolerance due to heart or lung compression.
- Psychosocial issues: Self-esteem concerns or social anxiety due to appearance.
- Cardiac or pulmonary dysfunction: Rarely, severe cases impair heart or lung function.
Pectus excavatum repair is indicated for:
- Symptomatic patients with functional limitations (e.g., breathing difficulties, heart compression).
- Severe deformities (Haller’s index >3.25 on CT scan, indicating depth of indentation).
- Psychological distress impacting quality of life.
Why Do Pectus Excavatum Repair Costs Vary in Philippines?
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Pectus Excavatum Repair Procedure
The procedure is tailored to the patient’s age, severity of deformity, and overall health:
- Before Surgery Evaluation:
- Diagnosis is confirmed via physical exam and imaging (CT scan or MRI) to measure the Haller’s index and assess heart/lung compression.
- Pulmonary function tests (PFTs) and echocardiograms evaluate lung and heart function.
- Psychological assessments may address body image concerns, especially in adolescents.
- Blood tests and consultations ensure surgical fitness.
- Surgical Techniques:
- Nuss Procedure (Minimally Invasive):
- The gold standard, performed under general anesthesia, lasting 1–2 hours.
- Two small incisions are made on the sides of the chest, and a curved metal bar (Nuss bar) is inserted under the sternum using thoracoscopy (camera guidance).
- The bar is flipped to push the sternum outward, correcting the deformity, and secured with stabilizers.
- The bar remains in place for 2–3 years, removed via a minor outpatient procedure.
- Preferred for children and adolescents (ages 12–18) due to chest flexibility and faster recovery.
- Ravitch Procedure (Open Surgery):
- Used for complex or severe cases, or in adults with less flexible chests, lasting 3–5 hours.
- A larger incision is made across the chest, and abnormal cartilage is removed from the ribs and sternum.
- The sternum is reshaped, sometimes with a temporary metal strut or mesh for support.
- Involves longer recovery and more scarring but is effective for rigid deformities.
- Modified or Hybrid Approaches:
- Some centers combine Nuss and Ravitch elements for tailored correction, especially in adults or asymmetric cases.
- Nuss Procedure (Minimally Invasive):
- After Surgery:
- Patients are monitored in the hospital for 3–5 days (Nuss) or 5–7 days (Ravitch), with pain management in the ICU or high-dependency unit for 1–2 days.
- Chest X-rays confirm bar or strut placement and lung expansion.
- Follow-up visits monitor healing and bar stability (Nuss) or cartilage regrowth (Ravitch).
Recovery After Pectus Excavatum Repair
Recovery varies by procedure and patient age:
- Hospital Stay:
- Nuss procedure requires 3–5 days, with 1–2 days in the ICU or high-dependency unit.
- Ravitch procedure involves 5–7 days, with 1–3 days in the ICU.
- Post-Surgery Care:
- Pain is significant initially, managed with epidural catheters, opioids, or NSAIDs (e.g., ibuprofen).
- Patients are encouraged to breathe deeply and use a spirometer to prevent lung complications.
- Antibiotics reduce infection risk, particularly for open surgery.
- Activity Restrictions:
- Light walking is encouraged within days to prevent blood clots.
- Strenuous activities, sports, or heavy lifting are avoided for 3–6 months (Nuss) or 6–12 months (Ravitch).
- Nuss patients must avoid twisting or lying on their side to protect the bar.
- School or work resumes in 2–4 weeks (Nuss) or 4–6 weeks (Ravitch), depending on pain tolerance.
- Follow-Up:
- Follow-up visits at 1, 3, and 6 months include chest X-rays to monitor bar/strut position and chest shape.
- Nuss bar removal occurs after 2–3 years, requiring a minor procedure.
- Long-term follow-ups ensure sustained correction and assess lung/heart function.
Most patients achieve full recovery within 3–6 months, with significant improvements in appearance, exercise capacity, and self-esteem. Success rates are 95–98%, with low recurrence rates (<5%) when performed by experienced surgeons.
Risks and Complications
Pectus excavatum repair is generally safe but carries risks:
- Surgical Risks:
- Bleeding or infection at the incision or bar site.
- Pneumothorax (collapsed lung), requiring chest tube placement.
- Nuss Procedure Risks:
- Bar displacement or migration, necessitating repositioning or removal.
- Chronic pain or bar irritation, affecting 5–10% of patients.
- Ravitch Procedure Risks:
- Excessive scarring or keloid formation.
- Cartilage regrowth issues, leading to recurrence (rare).
- General Risks:
- Adverse reactions to anesthesia.
- Blood clots or pneumonia, preventable with early mobilization and breathing exercises.
- Long-Term Issues:
- Minor asymmetry or incomplete correction in complex cases.
- Rarely, heart or lung injury during surgery.
Prompt reporting of symptoms like fever, chest pain, or breathing difficulties ensures timely management.
Frequently Asked Questions (FAQs)
What causes pectus excavatum?
It’s a congenital condition, often genetic, linked to abnormal cartilage growth. Family history or conditions like Marfan syndrome increase risk.
Is the Nuss procedure better than the Ravitch procedure?
Nuss is less invasive, with faster recovery and smaller scars, ideal for younger patients. Ravitch is better for complex or adult cases but involves longer recovery.
Can pectus excavatum be treated without surgery?
Mild cases may be managed with physical therapy or bracing (e.g., vacuum bell), but moderate to severe cases require surgery for functional or cosmetic benefits.
How soon can I resume normal activities?
Nuss patients resume light activities in 2–4 weeks and sports in 3–6 months; Ravitch patients take 4–6 weeks for light activities and 6–12 months for sports.
Is pectus excavatum repair covered by insurance in India?
Insurance may cover surgery for functional issues (e.g., breathing problems) but not always for cosmetic reasons. Confirm with your provider.
What are the signs of complications post-repair?
Fever, severe chest pain, shortness of breath, or bar movement (Nuss) require immediate medical attention.
Can adults undergo pectus excavatum repair?
Yes, adults can undergo repair, often with the Ravitch procedure or modified Nuss, though recovery may be slower due to less chest flexibility.
Will my chest look normal after surgery?
Most patients achieve a near-normal chest appearance, with significant cosmetic and functional improvements, though minor asymmetry may persist.
Conclusion
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Looking for Best Hospitals for Pectus Excavatum Repair
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.