The Operative Correction of Pectus Deformities: A Prospective Cohort Study

Mahmoud Ahmed  Al-Shafiey; Ibrahim  Kasb; Yousry  Shaheen; Hany Muhammed Abdel Mageed Eletr; Ahmed Sobhy Emara

Mahmoud Ahmed Al-Shafiey Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Ibrahim Kasb Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Yousry Shaheen Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Hany Muhammed Abdel Mageed Eletr Department of Cardiothoracic Surgery, Nasser Institute, Cairo, Egypt
Ahmed Sobhy Emara Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt

Keywords: Pectus deformity, Pectus excavatum, Pectus carinatum, Modified Ravitch procedure, Nuss procedure, Chest wall reconstruction, Surgical outcomes

Abstract

Background: Pectus deformities represent the most common congenital chest wall abnormalities, significantly impacting both physiological function and psychological well-being of aﬀected patients. While multiple surgical approaches exist, the outcomes of surgical repair remain a subject of ongoing investigation. The objectives of this study were to evaluate the psychological impacts of pectus deformities with assessment of psychological satisfaction of the patient and his family post operative and assess improvements of physiological impacts of these deformities post operative

Methods: This prospective cohort study was conducted at xxxxx from 2022 to 2025. Fifty patients with pectus deformities underwent surgical correction using either the Modified Ravitch procedure (n=28, 56%) or the Nuss procedure (n=22, 44%). Outcomes included postoperative assessment scores (poor, fair, good, excellent), hospital stay duration, complications, and patient satisfaction.

Results: The study population consisted of 38 males (76%) and 12 females (24%) with a mean age of 14.8 ± 1.9 years. Pectus excavatum was the predominant deformity (86%, n=43), with pectus carinatum comprising 14% (n=7). Severity distribution showed 26% severe cases, with the remainder classified as moderate or mild. The overall excellent outcome rate was 42% (21/50), with 50% achieving good outcomes. Median hospital stay was 9 (8- 10) days, showing positive correlation with Haller index (r=0.33, p=0.026). The recurrence rate was low at 4% (2/50), and psychological satisfaction was achieved in 94% of patients.

Conclusions: Surgical techniques for pectus repair demonstrated high success rates with low morbidity. The Nuss procedure and Modified Ravitch procedure remains a reliable option with good to excellent outcomes in most cases.