Pectus excavatum repair

Description:
While the child is deep asleep and pain-free (using general anesthesia), an incision is made over the breastbone (sternum). The deformed cartilages are removed and the rib lining is left in place to allow regrowth of the cartilages. An incision is made in the sternum and it is repositioned. A rib or metal strut may be used to stabilize the sternum in normal position until healing occurs in 3 to 6 months. A chest tube may be placed to reexpand the lung if the lining of the lung is entered.

Metal struts are removed 6 months later through a small skin incision under the arm. This procedures is usually done as an outpatient.

Indications:
Repair of pectus excavatum may be recommended for:
  • improved appearance (cosmetic repair)
  • improved breathing ( respiratory function)



What to Expect After:
Satisfactory repair is usually achieved with surgery. Recurrence of the deformity affects 10% to 15% of patients. Many affected children have other connective tissue disorders.

Convalescence:
Hospitalization for 1 week is common. Vigorous activity may need to be restricted for 3 months.

Risks:
Risks for any anesthesia are:

Risks for any surgery are:

Additional risks may include:

Costs:
The costs of any surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are younger, sicker, or need more extensive surgery will require more intensive and expensive treatment.

Surgery charges can be separated into five parts: 1) the surgeon's fee, 2) the anesthesiologist's fee, 3) the hospital charges, which includes nursing care and the operating room, 4) the medications, and 5) additional charges.

1. Surgeon's fee: approximately $1,500
2. Anesthesiologist's fee: averages $350 to $400 per hour
3. Hospital charges: basic rate averages $1,500 to $1,800 per day (more for the intensive care unit (ICU) or private rooms)
4. Medication charges: $200 to $400
5. Additional charges: assisting surgeon, treatment of complications, diagnostic procedures (such as blood or X-ray exams), medical supplies, or equipment use.

Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.


Pectus excavatum is a condition in which the