Pectus excavatum should see which department?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on December 09, 2024
00:00
00:00

If the patient is relatively young, under 14 years old, and wishes to consult about pectus excavatum care, pediatric healthcare can be considered. However, if the patient is older, or in addition to pediatric healthcare advice, seeks information on how to treat pectus excavatum, it is advisable to consult with a local thoracic surgery department, if available. This is because thoracic surgeons offer not only information on the causes or care of pectus excavatum but also treatment options. Both conservative treatment plans and surgical interventions are available from thoracic surgeons. Of course, not all hospitals have a department of thoracic surgery, but general top-tier hospitals typically do; if there is no thoracic surgery available locally, considering general surgery might be the only alternative.

Other Voices

doctor image
home-news-image
Written by Zhang Zhi Gong
Cardiothoracic Surgery
48sec home-news-image

Funnel chest surgery principle

The Wang procedure, named after Director Wang Wenlin from the Second People's Hospital of Guangdong Province, is a surgical method for correcting pectus excavatum. Traditional minimally invasive techniques for correcting pectus excavatum, such as the Nuss procedure or its modifications, involve placing a metal bar under or behind the sternum, forming an arch to lift the depressed area, similar to a traditional arch bridge. In contrast, the Wang procedure positions the metal bar on top and in front of the sunken sternum, and then uses stainless steel wires to suspend the deformed sternum forward and upward, transforming the traditional arch into a modern cable-stayed bridge, thus suspending the depressed chest area.

doctor image
home-news-image
Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min 6sec home-news-image

What should be noted in daily life for people with funnel chest?

Since pectus excavatum is an inward and backward depression, such a depression may gradually become apparent even from a young age, especially worsening during adolescence. Therefore, children or patients with this condition should be aware of any significant lack of calcium or vitamin D. Of course, since pectus excavatum may also be somewhat related to familial genetic factors, it is important to check whether the child has any congenital heart diseases, Noonan syndrome, or connective tissue disorders. Since pectus excavatum causes an inward and backward indentation that compresses the heart and lungs, children with this condition may not be able to fully expand their lungs or completely relax their hearts. Consequently, these children tend to have a weaker constitution and may catch colds easily. Therefore, children with pectus excavatum should avoid crowded places, as their weaker constitution makes them more susceptible to colds, which can exacerbate their developmental issues, thus creating a vicious cycle.

doctor image
home-news-image
Written by Zhang Zhi Gong
Cardiothoracic Surgery
52sec home-news-image

Is the funnel chest suction cup effective?

If the patient is young and the chest wall still retains some elasticity, or there is a possibility of secondary development, then it might be worth trying a pectus excavatum suction cup. If during the development of the chest wall, the patient's family can actively encourage or supervise the use of the suction cup for over two hours a day, continuing for six months, preferably up to about two years, the suction cup can be somewhat effective. However, if the patient's chest wall is hard and lacks elasticity, or if there is little possibility of further development, then the suction cup might not be suitable for such patients. For patients whose chest wall has fully developed, the best or most definitive treatment for pectus excavatum is surgery. Therefore, while the pectus excavatum suction cup can be useful for some patients, it is not suitable for all patients.

doctor image
home-news-image
Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min 32sec home-news-image

Harm of pectus excavatum

The dangers of pectus excavatum can generally be divided into two aspects: one is the harm to the physiological functions of the patient, and the other is the psychological impact on the patient. The physiological harm can be further divided into two categories: one is the impact on lung function, and the other is the impact on heart function. We can imagine that in normal individuals, the sternum is positioned in front of the heart and lungs. However, in patients with pectus excavatum, due to congenital hereditary or genetic factors, the sternum is pushed backward towards the spine, compressing inward and backward, which causes the heart to be squeezed, deformed, and the lungs to be compressed, preventing them from fully expanding. Thus, both the heart and lungs of the patient are subjected to certain pressures, affecting both cardiac and pulmonary functions. In addition to the impact on cardiopulmonary function, the patient's thoracic cage is deformed. It appears as if the center of the chest has been punched in. This kind of deformed chest affects the patient's social abilities, including interactions with potential boyfriends or girlfriends. Imagine, for instance, removing one's shirt at the pool in summer, attracting stares as if one were a monster. Therefore, patients may lack confidence, especially in romantic and social interactions, and some may even experience certain levels of depression or suicidal tendencies.

doctor image
home-news-image
Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min 13sec home-news-image

Minimally invasive surgery for pectus excavatum

Pectus excavatum minimally invasive surgery currently comes in two varieties. The first resembles a variation of the traditional Nuss procedure, which involves making a small incision under the patient's armpit and inserting a pre-shaped trapezoidal steel plate through this small hole to the back of the depressed breastbone. The steel plate is then flipped to push out the depression. Because it requires only a one to two centimeter incision on the patient, it is considered much less invasive compared to the traditional Nuss procedure which requires two incisions. There is also another type of minimally invasive surgery which involves bilateral incisions but does not require flipping the steel plate, thus avoiding damage associated with flipping and muscle disruption between the ribs. This is also considered a current minimally invasive surgical technique. Additionally, there is the recent Wang procedure, which is also minimally invasive, requiring only one incision and not necessitating access behind the breastbone. However, it is generally suitable only for younger patients with softer breastbones. For older adults, the Wang procedure might not be appropriate and further observation is required.