The comparison of surgical correction of recurrent pectus excavatum with crossing wire construction and ravitch technique

Aim of the study. The article compares the method of surgical treatment using a crossing wire construction with the modified Ravitch operation for recurrent pectus excavatum. Methods. Between 2010 and 202, in our center twenty-four patients with recurrent pectus excavatum were operated. 15 patients underwent modified Ravitch technique with sternocostal plate and 9 patients were operated by open toracoplasty with crossing wire construction. The primary end point was Haller index change after operation. The secondary end points included length of stay after operation, short-term and long-term complications. Results and discussion. The mean patient age was 19.1±2.87 years. The mean Haller index was 4.45±2.78, the Gizhitskaya index – 0.7±0.1. A toracoplasty with cross wire construction was performed in 9 patients. There was no perioperative death. The Haller index reduced to 2,9±1,76 after the operation. During the follow-up, there were 1 patient who developed wound marginal necrosis; hemothorax in 2 patients and pneumothorax in 1 patient. Conclusions. Reoperation for recurrent pectus defects is a challenging undertaking. The results of our study showed that patients with recurrent pectus excavatum can safely undergo reoperation by toracoplasty with cross wire construction, and achieve satisfactory results.