Surgical treatment of children with asymmetric pectus excavatum: Literature review

Abstract

BACKGROUND: The surgical treatment of children with pectus excavatum is regarded as an urgent problem still demanding solution despite the multitudes of surgical correction methods available nowadays. The currently available well-known techniques cannot be considered perfect because they are not proper enough for solving all the tasks, not to mention the problem of asymmetric forms of pectus excavatum treatment.

AIM: To analyze publications containing information on the methods of surgical treatment used for children with pectus excavatum.

MATERIALS AND METHODS: The study presents the results of literature review on the methods of surgical correction of pectus excavatum. Information was retrieved in PubMed, Google Scholar, and eLibrary scientific databases using keywords. Consequently, 63 foreign and domestic scientific sources over the period from 1609 to 2022 were identified. Among them, 29 publications refer to the latest decade.

RESULTS: Given the variety of methods used for chest deformity correction, thoracoplasty by D. Nuss has become the “gold standard” for the treatment of pectus excavatum. However, according to the search results, it is impossible to name one universal method of surgical intervention that could solve all the urgent problems at present. Modern surgery methods used for pectus excavatum correction can be considered only as modifications of treatment methods having been used before.

CONCLUSIONS: The shortcomings of modern thoracoplasty determine the necessity to keep searching for new techniques and improve those available at present. Besides, the standard suitable for both surgeons and patients should be elaborated.

Keywords

asymmetric, pectus excavatum / thoracoplasty / children

References

[1] Bauhinus JJ. An observatory of rare, novel, wonderful, and monstrous medicines: the second book. The vital parts, contained in the chest. Frankfurt; 1609. (In Lat.)

[2] Bauhinus J.J. Observatorium medicarum, rararum, novarum, admirabilium, et montrosarum, liber secundus // De partibus vitalibus, thorace contentis. Frankfurt, 1609.

[3] Bauhinus JJ. An observatory of rare, novel, wonderful, and monstrous medicines: the second book. The vital parts, contained in the chest. Frankfurt; 1609. (In Lat.)

[4] Coln E, Carrasco J, Coln D. Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum. J Pediatr Surg. 2006;41(4):683−686. DOI: 10.1016/j.jpedsurg.2005.12.009

[5] Coln E., Carrasco J., Coln D. Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum // J. Pediatr. Surg. 2006. Vol. 41. No. 4. P. 683–686. DOI: 10.1016/j.jpedsurg.2005.12.009

[6] Coln E, Carrasco J, Coln D. Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum. J Pediatr Surg. 2006;41(4):683−686. DOI: 10.1016/j.jpedsurg.2005.12.009

[7] Koumbourlis AC, Stolar CJ. Lung growth and function in children and adolescents with idiopathic pectus excavatum. Pediatr Pulmonol. 2004;38(4):339−343. DOI: 10.1002/ppul.20062

[8] Koumbourlis A.C., Stolar C.J. Lung growth and function in children and adolescents with idiopathic pectus excavatum // Pediatr. Pulmonol. 2004. Vol. 38. No. 4. P. 339–343. DOI: 10.1002/ppul.20062

[9] Koumbourlis AC, Stolar CJ. Lung growth and function in children and adolescents with idiopathic pectus excavatum. Pediatr Pulmonol. 2004;38(4):339−343. DOI: 10.1002/ppul.20062

[10] Kelly REJr, Cash TF, Shamberger RC, et al. Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: multicenter study. Pediatrics. 2008;122(6):1218−1222. DOI: 10.1542/peds.2007-2723

[11] Kelly R.E.Jr., Cash T.F., Shamberger R.C., et al. Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: multicenter study // Pediatrics. 2008. Vol. 122. No. 6. P. 1218–1222. DOI: 10.1542/peds.2007-2723

[12] Kelly REJr, Cash TF, Shamberger RC, et al. Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: multicenter study. Pediatrics. 2008;122(6):1218−1222. DOI: 10.1542/peds.2007-2723

[13] Humphreys GH, Jaretzki A. Pectus excavatum. Late results with and without operation. J Thorac Cardiovasc Surg. 1980;80(5):686−695.

[14] Humphreys G.H., Jaretzki A. Pectus excavatum. Late results with and without operation // J. Thorac. Cardiovasc. Surg. 1980. Vol. 80. No. 5. P. 686–695.

[15] Humphreys GH, Jaretzki A. Pectus excavatum. Late results with and without operation. J Thorac Cardiovasc Surg. 1980;80(5):686−695.

[16] Lacquet LK, Morshuis WJ, Folgering HT. Long-term results after correction of anterior chest wall deformities. J Cardiovasc Surg (Torino). 1998;39(5):683−688.

[17] Lacquet L.K., Morshuis W.J., Folgering H.T. Long-term results after correction of anterior chest wall deformities // J. Cardiovasc. Surg. (Torino). 1998. Vol. 39. No. 5. P. 683–688.

[18] Lacquet LK, Morshuis WJ, Folgering HT. Long-term results after correction of anterior chest wall deformities. J Cardiovasc Surg (Torino). 1998;39(5):683−688.

[19] Abdrakhmanov AZh, Tazhin KB, Anashev TS. Congenital chest deformations and its treatment. Travmatologiya zhene Ortopediya. 2010;(1):3−7 (In Russ.)

[20] Абдрахманов А.Ж., Тажин К.Б., Анашев Т.С. Врожденные деформации грудной клетки и их лечение // Травматология жэне Ортопедия. 2010. № 1. С. 3–7.

[21] Abdrakhmanov AZh, Tazhin KB, Anashev TS. Congenital chest deformations and its treatment. Travmatologiya zhene Ortopediya. 2010;(1):3−7 (In Russ.)

[22] Rudakov SS. Metod kombinirovannogo lecheniya voronkoobraznoi deformatsii grudnoi kletki u detei s sindromom Marfana i marfanopodobnym fenotipom. Мoscow; 1996. (In Russ.)

[23] Рудаков С.С. Метод комбинированного лечения воронкообразной деформации грудной клетки у детей с синдромом Марфана и марфаноподобным фенотипом. Москва, 1996.

[24] Rudakov SS. Metod kombinirovannogo lecheniya voronkoobraznoi deformatsii grudnoi kletki u detei s sindromom Marfana i marfanopodobnym fenotipom. Мoscow; 1996. (In Russ.)

[25] Razumovsky AYu, Alkhasov AB, Razin MP, et al. Сomparative characteristics of the efficiency of different methods of operational treatment for pectus excavatum in children: a multicenter study. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2018;6(1):5−13. DOI: 10.17816/PTORS615-13

[26] Разумовский А.Ю., Алхасов А.Б., Разин М.П., и др. Сравнительная характеристика эффективности различных способов оперативного лечения воронкообразной деформации грудной клетки у детей: мультицентровое исследование // Ортопедия, травматология и восстановительная хирургия детского возраста. 2018. Т. 6. Вып. 1. С. 5–13. DOI: 10.17816/PTORS615-13

[27] Razumovsky AYu, Alkhasov AB, Razin MP, et al. Сomparative characteristics of the efficiency of different methods of operational treatment for pectus excavatum in children: a multicenter study. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2018;6(1):5−13. DOI: 10.17816/PTORS615-13

[28] Komolkin IA. Khirurgicheskoe lechenie vrozhdennykh deformatsii grudnoi kletki u detei [abstract dissertation]. Saint Peterburg; 2019. (In Russ.)

[29] Комолкин И.А. Хирургическое лечение врожденных деформаций грудной клетки у детей: дис. ... д-ра мед. наук. Санкт-Петербург, 2019.

[30] Komolkin IA. Khirurgicheskoe lechenie vrozhdennykh deformatsii grudnoi kletki u detei [abstract dissertation]. Saint Peterburg; 2019. (In Russ.)

[31] Vishnevskii AA, Rudakov SS, Milanov NO. Khirurgiya grudnoi stenki: rukovodstvo. Moscow: Vidar; 2005. (In Russ.)

[32] Вишневский А.А., Рудаков С.С., Миланов Н.О. Хирургия грудной стенки: руководство. Москва: Видар, 2005.

[33] Vishnevskii AA, Rudakov SS, Milanov NO. Khirurgiya grudnoi stenki: rukovodstvo. Moscow: Vidar; 2005. (In Russ.)

[34] Horch RE, Stoelben E, Carbon R, et al. Pectus excavatum breast and chest deformity: indications for aesthetic plastic surgery versus thoracic surgery in a multicenter experience. Aesthetic Plast Surg. 2006;30(4):403−411. DOI: 10.1007/s00266-004-0138-x

[35] Horch R.E., Stoelben E., Carbon R., et al. Pectus excavatum breast and chest deformity: indications for aesthetic plastic surgery versus thoracic surgery in a multicenter experience // Aesthetic Plast. Surg. 2006. Vol. 30. No. 4. P. 403–411. DOI: 10.1007/s00266-004-0138-x

[36] Horch RE, Stoelben E, Carbon R, et al. Pectus excavatum breast and chest deformity: indications for aesthetic plastic surgery versus thoracic surgery in a multicenter experience. Aesthetic Plast Surg. 2006;30(4):403−411. DOI: 10.1007/s00266-004-0138-x

[37] Haecker FM, Krebs T, Kocher GJ, et al. Sternal elevation techniques during the minimally invasive repair of pectus excavatum. Interact Cardiovasc Thorac Surg. 2019;29(4):497−502. DOI: 10.1093/icvts/ivz142

[38] Haecker F.M., Krebs T., Kocher G.J., et al. Sternal elevation techniques during the minimally invasive repair of pectus excavatum // Interact. Cardiovasc. Thorac. Surg. 2019. Vol. 29. No. 4. P. 497–502. DOI: 10.1093/icvts/ivz142

[39] Haecker FM, Krebs T, Kocher GJ, et al. Sternal elevation techniques during the minimally invasive repair of pectus excavatum. Interact Cardiovasc Thorac Surg. 2019;29(4):497−502. DOI: 10.1093/icvts/ivz142

[40] Kuru P, Cakiroglu A, Er A, et al. Pectus excavatum and pectus carinatum: associated conditions, family history, and postoperative patient satisfaction. Korean J Thorac Cardiovasc Surg. 2016;49(1):29−34. DOI: 10.5090/kjtcs.2016.49.1.29

[41] Kuru P., Cakiroglu A., Er A., et al. Pectus excavatum and pectus carinatum: associated conditions, family history, and postoperative patient satisfaction // Korean J. Thorac. Cardiovasc. Surg. 2016. Vol. 49. No. 1. P. 29–34. DOI: 10.5090/kjtcs.2016.49.1.29

[42] Kuru P, Cakiroglu A, Er A, et al. Pectus excavatum and pectus carinatum: associated conditions, family history, and postoperative patient satisfaction. Korean J Thorac Cardiovasc Surg. 2016;49(1):29−34. DOI: 10.5090/kjtcs.2016.49.1.29

[43] Aprosimova SI. Optimizatsiya khirurgicheskogo lecheniya voronkoobraznoi deformatsii grudnoi kletki u detei [abstract dissertation]. Moscow; 2020. (In Russ.)

[44] Апросимова С.И. Оптимизация хирургического лечения воронкообразной деформации грудной клетки у детей: автореф. ... дис. канд. мед. наук. Москва, 2020.

[45] Aprosimova SI. Optimizatsiya khirurgicheskogo lecheniya voronkoobraznoi deformatsii grudnoi kletki u detei [abstract dissertation]. Moscow; 2020. (In Russ.)

[46] Khaspekov DV. Sravnitel’nyi analiz khirurgicheskikh metodov lecheniya voronkoobraznoi deformatsii grudnoi kletki u detei i podrostkov [abstract dissertation]. Moscow; 2021. (In Russ.)]

[47] Хаспеков Д.В. Сравнительный анализ хирургических методов лечения воронкообразной деформации грудной клетки у детей и подростков: дис. ... канд. мед. наук. Москва, 2021.

[48] Khaspekov DV. Sravnitel’nyi analiz khirurgicheskikh metodov lecheniya voronkoobraznoi deformatsii grudnoi kletki u detei i podrostkov [abstract dissertation]. Moscow; 2021. (In Russ.)]

[49] Okuyama H, Tsukada R, Tazuke Y, et al. Thoracoscopic costal cartilage excision combined with the nuss procedure for patients with asymmetrical pectus excavatum. J Laparoendosc Adv Surg Tech A. 2021;31(1):95−99. DOI: 10.1089/lap.2020.0312

[50] Okuyama H., Tsukada R., Tazuke Y., et al. Thoracoscopic costal cartilage excision combined with the nuss procedure for patients with asymmetrical pectus excavatum // J. Laparoendosc. Adv. Surg. Tech. A. 2021. Vol. 31. No. 1. P. 95–99. DOI: 10.1089/lap.2020.0312

[51] Okuyama H, Tsukada R, Tazuke Y, et al. Thoracoscopic costal cartilage excision combined with the nuss procedure for patients with asymmetrical pectus excavatum. J Laparoendosc Adv Surg Tech A. 2021;31(1):95−99. DOI: 10.1089/lap.2020.0312

[52] Pawlak K, Gąsiorowski Ł, Dyszkiewicz W. Complex corrective procedure in surgical treatment of asymmetrical pectus excavatum. Kardiochir Torakochirurgia Pol. 2017;14(2):110−114. (In Pol.). DOI: 10.5114/kitp.2017.68741

[53] Pawlak K., Gąsiorowski Ł., Dyszkiewicz W. Complex corrective procedure in surgical treatment of asymmetrical pectus excavatum // Kardiochir. Torakochirurgia Pol. 2017. Vol. 14. No. 2. P. 110–114. DOI: 10.5114/kitp.2017.68741

[54] Pawlak K, Gąsiorowski Ł, Dyszkiewicz W. Complex corrective procedure in surgical treatment of asymmetrical pectus excavatum. Kardiochir Torakochirurgia Pol. 2017;14(2):110−114. (In Pol.). DOI: 10.5114/kitp.2017.68741

[55] Komolkin IA, Afanas’yev AP, Shchegolev DV. The role of heredity in the occurrence of the chest congenital deformities (review of the literature). Geniy ortopedii. 2012;(2):152−156. (In Russ.)

[56] Комолкин И.А., Афанасьев А.П., Щеголев Д.В. Роль наследственности в происхождении врожденных деформаций грудной клетки (обзор литературы) // Гений ортопедии. 2012. № 2. С. 152−156.

[57] Komolkin IA, Afanas’yev AP, Shchegolev DV. The role of heredity in the occurrence of the chest congenital deformities (review of the literature). Geniy ortopedii. 2012;(2):152−156. (In Russ.)

[58] Jaroszewski D, Notrica D, McMahon L, et al. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. J Am Board Fam Med. 2010;23(2):230−239. DOI: 10.3122/jabfm.2010.02.090234

[59] Jaroszewski D., Notrica D., McMahon L., et al. Current management of pectus excavatum: a review and update of therapy and treatment recommendations // J. Am. Board Fam. Med. 2010. Vol. 23. No. 2. P. 230–239. DOI: 10.3122/jabfm.2010.02.090234

[60] Jaroszewski D, Notrica D, McMahon L, et al. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. J Am Board Fam Med. 2010;23(2):230−239. DOI: 10.3122/jabfm.2010.02.090234

[61] Malek MH, Berger DE, Housh TJ, et al. Cardiovascular function following surgical repair of pectus excavatum: a metaanalysis. Chest. 2006;130(2):506−516. DOI: 10.1378/chest.130.2.506

[62] Malek M.H., Berger D.E., Housh T.J., et al. Cardiovascular function following surgical repair of pectus excavatum: a metaanalysis // Chest. 2006. Vol. 130. No. 2. P. 506–516. DOI: 10.1378/chest.130.2.506

[63] Malek MH, Berger DE, Housh TJ, et al. Cardiovascular function following surgical repair of pectus excavatum: a metaanalysis. Chest. 2006;130(2):506−516. DOI: 10.1378/chest.130.2.506

[64] Kuznechikhin EP, Ul’rikh EV. Khirurgicheskoe lechenie detei s zabolevaniyami i deformatsiyami oporno-dvigatel’noi sistemy. Moscow: Meditsina; 2004. (In Russ.)

[65] Кузнечихин Е.П., Ульрих Э.В. Хирургическое лечение детей с заболеваниями и деформациями опорно-двигательной системы. Москва: Медицина, 2004.

[66] Kuznechikhin EP, Ul’rikh EV. Khirurgicheskoe lechenie detei s zabolevaniyami i deformatsiyami oporno-dvigatel’noi sistemy. Moscow: Meditsina; 2004. (In Russ.)

[67] Cohen PR. Poland’s syndrome: are postzygotic mutations in β-actin associated with its pathogenesis? Am J Clin Dermatol. 2018;19(1):133–134. DOI: 10.1007/s40257-017-0330-9

[68] Cohen P.R. Poland’s syndrome: are postzygotic mutations in β-actin associated with its pathogenesis? // Am. J. Clin. Dermatol. 2018. Vol. 19. No. 1. P. 133–134. DOI: 10.1007/s40257-017-0330-9

[69] Cohen PR. Poland’s syndrome: are postzygotic mutations in β-actin associated with its pathogenesis? Am J Clin Dermatol. 2018;19(1):133–134. DOI: 10.1007/s40257-017-0330-9

[70] Sauerbruch F. Operative beseitigung der angeborenen trichterbrust. Deutsche Zeitschrift F Chirurgie. 1931;234:760–764. (In Deu.). DOI: 10.1007/BF02797645

[71] Sauerbruch F. Operative beseitigung der angeborenen trichterbrust // Deutsche Zeitschrift f. Chirurgie. 1931. Vol. 234. P. 760–764. DOI: 10.1007/BF02797645

[72] Sauerbruch F. Operative beseitigung der angeborenen trichterbrust. Deutsche Zeitschrift F Chirurgie. 1931;234:760–764. (In Deu.). DOI: 10.1007/BF02797645

[73] Meyer L. Zurchirurgischen Behandlung der angeborenen Trichterbrust. Berl Klin Wschr. 1911;48:1563–1566. (In Deu.)

[74] Meyer L. Zurchirurgischen behandlung der angeborenen trichterbrust // Berl. Klin. Wschr. 1911. Vol. 48. P. 1563–1566.

[75] Meyer L. Zurchirurgischen Behandlung der angeborenen Trichterbrust. Berl Klin Wschr. 1911;48:1563–1566. (In Deu.)

[76] Schulz-Drost S, Syed J, Luber AM, et al. From pullout-techniques to modular elastic stable chest repair: the evolution of an open technique in the correction of pectus excavatum. J Thorac Dis. 2019;11(7):2846–2860. DOI: 10.21037/jtd.2019.07.01

[77] Schulz-Drost S., Syed J., Luber A.M., et al. From pullout-techniques to modular elastic stable chest repair: the evolution of an open technique in the correction of pectus excavatum // J. Thorac. Dis. 2019. Vol. 11. No. 7. P. 2846–2860. DOI: 10.21037/jtd.2019.07.01

[78] Schulz-Drost S, Syed J, Luber AM, et al. From pullout-techniques to modular elastic stable chest repair: the evolution of an open technique in the correction of pectus excavatum. J Thorac Dis. 2019;11(7):2846–2860. DOI: 10.21037/jtd.2019.07.01

[79] Kuritsyn VM, Shabanov AM, Shekhonin B, et al. Patogistologiya rebernogo khryashcha i immunomorfologicheskaya kharakteristika kollagena pri voronkoobraznoi grudi. Arkhiv patologii. 1987;49(1):20–26. (In Russ.)

[80] Курицын В.М., Шабанов А.М., Шехонин Б., и др. Патогистология реберного хряща и иммуноморфологическая характеристика коллагена при воронкообразной груди // Архив патологии. 1987. Вып. 49. №. 1. С. 20–26.

[81] Kuritsyn VM, Shabanov AM, Shekhonin B, et al. Patogistologiya rebernogo khryashcha i immunomorfologicheskaya kharakteristika kollagena pri voronkoobraznoi grudi. Arkhiv patologii. 1987;49(1):20–26. (In Russ.)

[82] Pavlova VN, Kop’yeva TN, Slutskiy LI, et al. Khryashch. Moscow; 1988. (In Russ.)

[83] Павлова В.Н., Копьева Т.Н., Слуцкий Л.И., и др. Хрящ. Москва, 1988.

[84] Pavlova VN, Kop’yeva TN, Slutskiy LI, et al. Khryashch. Moscow; 1988. (In Russ.)

[85] Polyudov SA, Goritskaya TA, Verovskii VA, et al. Voronkoobraznaya deformatsiya grudnoi kletki u detei. Detskaya bol’nitsa. 2005;(4):34−39. (In Russ.)

[86] Полюдов С.А., Горицкая Т.А., Веровский В.А., и др. Воронкообразная деформация грудной клетки у детей // Детская больница. 2005. № 4. С. 34−39.

[87] Polyudov SA, Goritskaya TA, Verovskii VA, et al. Voronkoobraznaya deformatsiya grudnoi kletki u detei. Detskaya bol’nitsa. 2005;(4):34−39. (In Russ.)

[88] Ravitch MM. The operative treatment of pectus excavatum. Ann Surg. 1949;129(4):429–44. DOI: 10.1097/00000658-194904000-00002

[89] Ravitch M.M. The operative treatment of pectus excavatum // Ann. Surg. 1949. Vol. 129. No. 4. P. 429–444. DOI: 10.1097/00000658-194904000-00002

[90] Ravitch MM. The operative treatment of pectus excavatum. Ann Surg. 1949;129(4):429–44. DOI: 10.1097/00000658-194904000-00002

[91] Ravitch MM. Congenital deformities of the chest wall and their operative correction. Philadelphia: W.B. Saunders Company; 1977.

[92] Ravitch M.M. Congenital deformities of the chest wall and their operative correction. Philadelphia: W.B. Saunders Company; 1977.

[93] Ravitch MM. Congenital deformities of the chest wall and their operative correction. Philadelphia: W.B. Saunders Company; 1977.

[94] Bairov GA. Operatsii pri vrozhdennoy voronkoobraznoy grudi. In: Operativnaya khirurgiya detskogo vozrasta. Ed. by Ye.M. Margorin. Leningrad; 1960. P. 139−142. (In Russ.)

[95] Баиров Г.А. Операции при врожденной воронкообразной груди // Оперативная хирургия детского возраста / под ред. Е.М. Маргорина. Ленинград, 1960. С. 139−142.

[96] Bairov GA. Operatsii pri vrozhdennoy voronkoobraznoy grudi. In: Operativnaya khirurgiya detskogo vozrasta. Ed. by Ye.M. Margorin. Leningrad; 1960. P. 139−142. (In Russ.)

[97] Judet J, Judet R. Funnel chest: an operative procedure. Rev Orihop. 1954;40:248−257. (In Fr.)

[98] Judet J., Judet R: Thorax en enionnoir: un procede operatoire // Rev. Orihop. 1954. Vol. 40. P. 248−257.

[99] Judet J, Judet R. Funnel chest: an operative procedure. Rev Orihop. 1954;40:248−257. (In Fr.)

[100] Nuss D, Kelly REJr, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg. 1998;33(4):545–552. DOI: 10.1016/s0022-3468(98)90314-1

[101] Nuss D., Kelly R.E.Jr., Croitoru D.P., et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum // J. Pediatr. Surg. 1998. Vol. 33. No. 4. P. 545−552. DOI: 10.1016/s0022-3468(98)90314-1

[102] Nuss D, Kelly REJr, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg. 1998;33(4):545–552. DOI: 10.1016/s0022-3468(98)90314-1

[103] Yoshida K, Kashimura T, Kikuchi Y, et al. Successful management for repeated bar displacements after Nuss method by two bars connected by a stabilizer. Ann Thorac Med. 2019;14(3):216–219. DOI: 10.4103/atm.ATM_84_19

[104] Yoshida K., Kashimura T., Kikuchi Y., et al. Successful management for repeated bar displacements after Nuss method by two bars connected by a stabilizer // Ann. Thorac. Med. 2019. Vol. 14. No. 3. P. 216−219. DOI: 10.4103/atm.ATM_84_19

[105] Yoshida K, Kashimura T, Kikuchi Y, et al. Successful management for repeated bar displacements after Nuss method by two bars connected by a stabilizer. Ann Thorac Med. 2019;14(3):216–219. DOI: 10.4103/atm.ATM_84_19

[106] Nuss D. Recent experiences with minimally invasive pectus excavatum repair “Nuss procedure”. Jpn J Thorac Cardiovasc Surg. 2005;53(7):338–344. DOI: 10.1007/s11748-005-0047-1

[107] Nuss D. Recent experiences with minimally invasive pectus excavatum repair “Nuss procedure” // Jpn. J. Thorac. Cardiovasc. Surg. 2005. Vol. 53. No. 7. P. 338−344. DOI: 10.1007/s11748-005-0047-1

[108] Nuss D. Recent experiences with minimally invasive pectus excavatum repair “Nuss procedure”. Jpn J Thorac Cardiovasc Surg. 2005;53(7):338–344. DOI: 10.1007/s11748-005-0047-1

[109] Nuss D, Croitoru DP, Kelly REJr, et al. Review and discussion of the complications of minimally invasive pectus excavatum repair. Eur J Pediatr Surg. 2002;12(4):230–234. DOI: 10.1055/s-2002-34485

[110] Nuss D., Croitoru D.P., Kelly R.E.Jr., et al. Review and discussion of the complications of minimally invasive pectus excavatum repair // Eur. J. Pediatr. Surg. 2002. Vol. 12. No. 4. P. 230−234. DOI: 10.1055/s-2002-34485

[111] Nuss D, Croitoru DP, Kelly REJr, et al. Review and discussion of the complications of minimally invasive pectus excavatum repair. Eur J Pediatr Surg. 2002;12(4):230–234. DOI: 10.1055/s-2002-34485

[112] Notrica DM. Modifications to the Nuss procedure for pectus excavatum repair: a 20-year review. Semin Pediatr Surg. 2018;27(3):133–150. DOI: 10.1053/j.sempedsurg.2018.05.004

[113] Notrica D.M. Modifications to the Nuss procedure for pectus excavatum repair: a 20-year review // Semin. Pediatr. Surg. 2018. Vol. 27. No. 3. P. 133−150. DOI: 10.1053/j.sempedsurg.2018.05.004

[114] Notrica DM. Modifications to the Nuss procedure for pectus excavatum repair: a 20-year review. Semin Pediatr Surg. 2018;27(3):133–150. DOI: 10.1053/j.sempedsurg.2018.05.004

[115] Lučenič M, Janík M, Juhos P, et al. Short-term results of minimally invasive pectus excavatum repair in adult patients. Rozhl Chir. 2016;95(1):25–32. (In Czech.)

[116] Lučenič M., Janík M., Juhos P., et al. Krátkodobé výsledky minimálne invazívnej korekcie pectus excavatum u dospelých pacientov // Rozhl. Chir. 2016. Vol. 95. No. 1. P. 25−32.

[117] Lučenič M, Janík M, Juhos P, et al. Short-term results of minimally invasive pectus excavatum repair in adult patients. Rozhl Chir. 2016;95(1):25–32. (In Czech.)

[118] Goretsky MJ, McGuire MM. Complications associated with the minimally invasive repair of pectus excavatum. Semin Pediatr Surg. 2018;27(3):151–155. DOI: 10.1053/j.sempedsurg.2018.05.001

[119] Goretsky M.J., McGuire M.M. Complications associated with the minimally invasive repair of pectus excavatum // Semin. Pediatr. Surg. 2018. Vol. 27. No. 3. P. 151−155. DOI: 10.1053/j.sempedsurg.2018.05.001

[120] Goretsky MJ, McGuire MM. Complications associated with the minimally invasive repair of pectus excavatum. Semin Pediatr Surg. 2018;27(3):151–155. DOI: 10.1053/j.sempedsurg.2018.05.001

[121] Hebra A, Kelly RE, Ferro MM, et al. Life-threatening complications and mortality of minimally invasive pectus surgery. J Pediatr Surg. 2018;53(4):728–732. DOI: 10.1016/j.jpedsurg.2017.07.020

[122] Hebra A., Kelly R.E., Ferro M.M., et al. Life-threatening complications and mortality of minimally invasive pectus surgery // J. Pediatr. Surg. 2018. Vol. 53. No. 4. P. 728−732. DOI: 10.1016/j.jpedsurg.2017.07.020

[123] Hebra A, Kelly RE, Ferro MM, et al. Life-threatening complications and mortality of minimally invasive pectus surgery. J Pediatr Surg. 2018;53(4):728–732. DOI: 10.1016/j.jpedsurg.2017.07.020

[124] Kelly RE Jr, Obermeyer RJ, Goretsky MJ, et al. Nuss d. recent modifications of the nuss procedure: the pursuit of safety during the minimally invasive repair of pectus excavatum. Ann Surg. 2022;275(2):e496–e502. DOI: 10.1097/SLA.0000000000003877

[125] Kelly R.E.Jr., Obermeyer R.J., Goretsky M.J., et al. Nuss d. recent modifications of the nuss procedure: the pursuit of safety during the minimally invasive repair of pectus excavatum // Ann. Surg. 2022. Vol. 275. No. 2. P. e496−e502. DOI: 10.1097/SLA.0000000000003877

[126] Kelly RE Jr, Obermeyer RJ, Goretsky MJ, et al. Nuss d. recent modifications of the nuss procedure: the pursuit of safety during the minimally invasive repair of pectus excavatum. Ann Surg. 2022;275(2):e496–e502. DOI: 10.1097/SLA.0000000000003877

[127] Haecker FM, Bielek J, von Schweinitz D. Minimally invasive repair of pectus excavatum (MIRPE) – the Basel experience. Swiss Surg. 2003;9(6):289–295. DOI: 10.1024/1023-9332.9.6.289

[128] Haecker F.M., Bielek J., von Schweinitz D. Minimally invasive repair of pectus excavatum (MIRPE) − the Basel experience // Swiss Surg. 2003. Vol. 9. No. 6. P. 289−295. DOI: 10.1024/1023-9332.9.6.289

[129] Haecker FM, Bielek J, von Schweinitz D. Minimally invasive repair of pectus excavatum (MIRPE) – the Basel experience. Swiss Surg. 2003;9(6):289–295. DOI: 10.1024/1023-9332.9.6.289

[130] Hebra A. Minor and major complications related to minimally invasive repair of pectus excavatum. Eur J Pediatr Surg. 2018;28(4):320–326. DOI: 10.1055/s-0038-1670690

[131] Hebra A. Minor and major complications related to minimally invasive repair of pectus excavatum // Eur. J. Pediatr. Surg. 2018. Vol. 28. No. 4. P. 320−326. DOI: 10.1055/s-0038-1670690

[132] Hebra A. Minor and major complications related to minimally invasive repair of pectus excavatum. Eur J Pediatr Surg. 2018;28(4):320–326. DOI: 10.1055/s-0038-1670690

[133] Stalmakhovich VN, Dyukov AA, Dmitrienko AP, et al. Rare complications after thoracoplasty in children with congenital pectus excavatum. Acta Biomedica Scientifica. 2015;(3):18–20. (In Russ.)

[134] Стальмахович В.Н., Дюков А.А., Дмитриенко А.П., и др. Редкие осложнения после торакопластики у детей с врожденной воронкообразной деформацией грудной клетки // Acta Biomedica Scientifica. 2015. № 3. С. 18−20.

[135] Stalmakhovich VN, Dyukov AA, Dmitrienko AP, et al. Rare complications after thoracoplasty in children with congenital pectus excavatum. Acta Biomedica Scientifica. 2015;(3):18–20. (In Russ.)

[136] Tetteh O, Rhee DS, Boss E, et al. Minimally invasive repair of pectus excavatum: analysis of the NSQIP database and the use of thoracoscopy. J Pediatr Surg. 2018;53(6):1230–1233. DOI: 10.1016/j.jpedsurg.2018.02.089

[137] Tetteh O., Rhee D.S., Boss E., et al. Minimally invasive repair of pectus excavatum: Analysis of the NSQIP database and the use of thoracoscopy // J. Pediatr. Surg. 2018. Vol. 53. No. 6. P. 1230−1233. DOI: 10.1016/j.jpedsurg.2018.02.089

[138] Tetteh O, Rhee DS, Boss E, et al. Minimally invasive repair of pectus excavatum: analysis of the NSQIP database and the use of thoracoscopy. J Pediatr Surg. 2018;53(6):1230–1233. DOI: 10.1016/j.jpedsurg.2018.02.089

[139] Graves CE, Hirose S, Raff GW, et al. Magnetic mini-mover procedure for pectus excavatum IV: FDA sponsored multicenter trial. J Pediatr Surg. 2017;52(6):913–919. DOI: 10.1016/j.jpedsurg.2017.03.009

[140] Graves C.E., Hirose S., Raff G.W., et al. Magnetic mini-mover procedure for pectus excavatum IV: FDA sponsored multicenter trial // J. Pediatr. Surg. 2017. Vol. 52. No. 6. P. 913−919. DOI: 10.1016/j.jpedsurg.2017.03.009

[141] Graves CE, Hirose S, Raff GW, et al. Magnetic mini-mover procedure for pectus excavatum IV: FDA sponsored multicenter trial. J Pediatr Surg. 2017;52(6):913–919. DOI: 10.1016/j.jpedsurg.2017.03.009

[142] Harrison MR, Estefan-Ventura D, Fechter R, et al. Magnetic mini-mover procedure for pectus excavatum: I. development, design, and simulations for feasibility and safety. J Pediatr Surg. 2007;42(1):81–85. DOI: 10.1016/j.jpedsurg.2006.09.042

[143] Harrison M.R., Estefan-Ventura D., Fechter R., et al. Magnetic mini-mover procedure for pectus excavatum: I. Development, design, and simulations for feasibility and safety // J. Pediatr. Surg. 2007. Vol. 42. No. 1. P. 81−85. DOI: 10.1016/j.jpedsurg.2006.09.042

[144] Harrison MR, Estefan-Ventura D, Fechter R, et al. Magnetic mini-mover procedure for pectus excavatum: I. development, design, and simulations for feasibility and safety. J Pediatr Surg. 2007;42(1):81–85. DOI: 10.1016/j.jpedsurg.2006.09.042

[145] Nordquist J, Svensson H, Johnsson M. Silastic implant for reconstruction of pectus excavatum: an update. Scand J Plast Reconstr Surg Hand Surg. 2001;35(1):65–69. DOI: 10.1080/02844310151032619

[146] Nordquist J., Svensson H., Johnsson M. Silastic implant for reconstruction of pectus excavatum: an update // Scand. J. Plast. Reconstr. Surg. Hand. Surg. 2001. Vol. 35. No. 1. P. 65−69. DOI: 10.1080/02844310151032619

[147] Nordquist J, Svensson H, Johnsson M. Silastic implant for reconstruction of pectus excavatum: an update. Scand J Plast Reconstr Surg Hand Surg. 2001;35(1):65–69. DOI: 10.1080/02844310151032619

[148] Snel BJ, Spronk CA, Werker PM, et al. Pectus excavatum reconstruction with silicone implants: long-term results and a review of the english-language literature. Ann Plast Surg. 2009;62(2):205–209. DOI: 10.1097/SAP.0b013e31817d878c

[149] Snel B.J., Spronk C.A., Werker P.M., et al. Pectus excavatum reconstruction with silicone implants: long-term results and a review of the english-language literature // Ann. Plast. Surg. 2009. Vol. 62. No. 2. P. 205−209. DOI: 10.1097/SAP.0b013e31817d878c

[150] Snel BJ, Spronk CA, Werker PM, et al. Pectus excavatum reconstruction with silicone implants: long-term results and a review of the english-language literature. Ann Plast Surg. 2009;62(2):205–209. DOI: 10.1097/SAP.0b013e31817d878c

[151] Hümmer HP, Willital GH. Classification and subclassification of funnel and pigeon chest. Z Orthop Ihre Grenzgeb. 1983;121(2):216–220. (In Deu.). DOI: 10.1055/s-2008-1051344.

[152] Hümmer H.P., Willital G.H. Klassifizierung und subklassifizierung der trichter- und kielbrust: classification and subclassification of funnel and pigeon chest // Z. Orthop. Ihre. Grenzgeb. 1983. Vol. 121. No. 2. P. 216−220. DOI: 10.1055/s-2008-1051344

[153] Hümmer HP, Willital GH. Classification and subclassification of funnel and pigeon chest. Z Orthop Ihre Grenzgeb. 1983;121(2):216–220. (In Deu.). DOI: 10.1055/s-2008-1051344.

[154] Länsman S, Serlo W, Linna O, et al. Treatment of pectus excavatum with bioabsorbable polylactide plates: preliminary results. J. Pediatr. Surg. 2002;37(9):1281−1286. DOI: 10.1053/jpsu.2002.34983

[155] Länsman S., Serlo W., Linna O., et al. Treatment of pectus excavatum with bioabsorbable polylactide plates: preliminary results // J. Pediatr. Surg. 2002. Vol. 37. No. 9. P. 1281−1286. DOI: 10.1053/jpsu.2002.34983

[156] Länsman S, Serlo W, Linna O, et al. Treatment of pectus excavatum with bioabsorbable polylactide plates: preliminary results. J. Pediatr. Surg. 2002;37(9):1281−1286. DOI: 10.1053/jpsu.2002.34983

[157] Krupko AV, Bogos’yan AB. Primenenie operatsii Nassa pri razlichnykh tipakh voronkoobraznoi deformatsii grudnoi kletki. Fundamental’nye issledovaniya. 2014;(10-2):298−303. (In Russ.)

[158] Крупко А.В., Богосьян А.Б. Применение операции Насса при различных типах воронкообразной деформации грудной клетки // Фундаментальные исследования. 2014. № 10. Ч. 2. С. 298−303.

[159] Krupko AV, Bogos’yan AB. Primenenie operatsii Nassa pri razlichnykh tipakh voronkoobraznoi deformatsii grudnoi kletki. Fundamental’nye issledovaniya. 2014;(10-2):298−303. (In Russ.)

[160] Tamai M, Nagasao T, Yanaga H, et al. Correction of secondary deformity after Nuss procedure for pectus excavatum by means of cultured autologous cartilage cell injection. Int J Surg Case Rep. 2015;15:70–73. DOI: 10.1016/j.ijscr.2015.08.031

[161] Tamai M., Nagasao T., Yanaga H., et al. Correction of secondary deformity after Nuss procedure for pectus excavatum by means of cultured autologous cartilage cell injection // Int. J. Surg. Case Rep. 2015. Vol. 15. No. 70−73. DOI: 10.1016/j.ijscr.2015.08.031

[162] Tamai M, Nagasao T, Yanaga H, et al. Correction of secondary deformity after Nuss procedure for pectus excavatum by means of cultured autologous cartilage cell injection. Int J Surg Case Rep. 2015;15:70–73. DOI: 10.1016/j.ijscr.2015.08.031

[163] Razumovskiy AYu., Pavlov AA. Khirurgicheskiye metody lecheniya voronkoobraznoy deformatsii grudnoy kletki. Detskaya khirurgiya. 2005;(3):44–47. (In Russ.)

[164] Разумовский А.Ю., Павлов А.А. Хирургические методы лечения воронкообразной деформации грудной клетки // Детская хирургия. 2005. №. 3. С. 44−47.

[165] Razumovskiy AYu., Pavlov AA. Khirurgicheskiye metody lecheniya voronkoobraznoy deformatsii grudnoy kletki. Detskaya khirurgiya. 2005;(3):44–47. (In Russ.)

[166] Park HJ, Jeong JY, Jo WM, et al. Minimally invasive repair of pectus excavatum: a novel morphology-tailored, patient-specific approach. J Thorac Cardiovasc Surg. 2010;139(2):379–386. DOI: 10.1016/j.jtcvs.2009.09.003

[167] Park H.J., Jeong J.Y., Jo W.M., et al. Minimally invasive repair of pectus excavatum: a novel morphology-tailored, patient-specific approach // J. Thorac. Cardiovasc. Surg. 2010. Vol. 139. No. 2. P. 379−386. DOI: 10.1016/j.jtcvs.2009.09.003

[168] Park HJ, Jeong JY, Jo WM, et al. Minimally invasive repair of pectus excavatum: a novel morphology-tailored, patient-specific approach. J Thorac Cardiovasc Surg. 2010;139(2):379–386. DOI: 10.1016/j.jtcvs.2009.09.003

[169] Park HJ, Lee SY, Lee CS, et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg. 2004;77(1):289–295. DOI: 10.1016/s0003-4975(03)01330-4

[170] Park H.J., Lee S.Y., Lee C.S., et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients // Ann. Thorac. Surg. 2004. Vol. 77. No. 1. P. 289−295. DOI: 10.1016/s0003-4975(03)01330-4

[171] Park HJ, Lee SY, Lee CS, et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg. 2004;77(1):289–295. DOI: 10.1016/s0003-4975(03)01330-4

[172] Squillaro AI, Melhado C, Ozgediz D, et al. Minimally invasive repair of asymmetric pectus excavatum: an alternative technique to treating asymmetric morphology. J Pediatr Surg. 2022;57(6):1079–1082. DOI: 10.1016/j.jpedsurg.2022.01.035

[173] Squillaro A.I., Melhado C., Ozgediz D., et al. Minimally invasive repair of asymmetric pectus excavatum: an alternative technique to treating asymmetric morphology // J. Pediatr. Surg. 2022. Vol. 57. No. 6. P. 1079−1082. DOI: 10.1016/j.jpedsurg.2022.01.035

[174] Squillaro AI, Melhado C, Ozgediz D, et al. Minimally invasive repair of asymmetric pectus excavatum: an alternative technique to treating asymmetric morphology. J Pediatr Surg. 2022;57(6):1079–1082. DOI: 10.1016/j.jpedsurg.2022.01.035

[175] Park HJ, Kim KS. The sandwich technique for repair of pectus carinatum and excavatum/carinatum complex. Ann Cardiothorac Surg. 2016;5(5):434–439. DOI: 10.21037/acs.2016.08.04

[176] Park H.J., Kim K.S. The sandwich technique for repair of pectus carinatum and excavatum/carinatum complex // Ann. Cardiothorac. Surg. 2016. Vol. 5. No. 5. P. 434−439. DOI: 10.21037/acs.2016.08.04

[177] Park HJ, Kim KS. The sandwich technique for repair of pectus carinatum and excavatum/carinatum complex. Ann Cardiothorac Surg. 2016;5(5):434–439. DOI: 10.21037/acs.2016.08.04

[178] Razumovsky AYu, Alkhasov AB, Mitupov ZB, et al. Analysis of perioperative complications of sunken chest correction by modified Nuss procedure. Russian Journal of Pediatric Surgery. 2017;21(5):251–257. (In Russ.). DOI: 10.18821/1560-9510-2017-21-5-251-257

[179] Разумовский А.Ю., Алхасов А.Б., Митупов З.Б., и др. Анализ периоперационных осложнений при коррекции ВДГК по модифицированной методике Насса // Детская хирургия. 2017. Вып. 21. № 5. С. 251−257. DOI: 10.18821/1560-9510-2017-21-5-251-257

[180] Razumovsky AYu, Alkhasov AB, Mitupov ZB, et al. Analysis of perioperative complications of sunken chest correction by modified Nuss procedure. Russian Journal of Pediatric Surgery. 2017;21(5):251–257. (In Russ.). DOI: 10.18821/1560-9510-2017-21-5-251-257

[181] Gatsutsyn VV, Nalivkin AE, Kuzmichev VA, et al. The substantiation of the differentiated approach in diagnostics and surgical correction of the funnel-shaped deformation of the chest in children. Russian Journal of Pediatric Surgery. 2018;22(4):199–204. (In Russ.). DOI: 10.18821/1560-9510-2018-22-4-199-204

[182] Гацуцын В.В., Наливкин А.Е., Кузьмичёв В.А., и др. Обоснование дифференцированного подхода в диагностике и хирургической коррекции воронкообразной деформации грудной клетки у детей // Детская хирургия. 2018. Вып. 22. №. 4. С. 199−204. DOI: 10.18821/1560-9510-2018-22-4-199-204

[183] Gatsutsyn VV, Nalivkin AE, Kuzmichev VA, et al. The substantiation of the differentiated approach in diagnostics and surgical correction of the funnel-shaped deformation of the chest in children. Russian Journal of Pediatric Surgery. 2018;22(4):199–204. (In Russ.). DOI: 10.18821/1560-9510-2018-22-4-199-204

[184] Khodzhanov IYu, Khakimov ShK, Kasymov KhA, et al. Voprosy diagnostiki i lecheniya voronkoobraznoy deformatsii grudnoy kletki u detey. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii. 2015;(1):40−46. (In Russ.)

[185] Ходжанов И.Ю., Хакимов Ш.К., Касымов Х.А., и др. Вопросы диагностики и лечения воронкообразной деформации грудной клетки у детей // Анналы пластической, реконструктивной и эстетической хирургии. 2015. № 1. С. 40−46.

[186] Khodzhanov IYu, Khakimov ShK, Kasymov KhA, et al. Voprosy diagnostiki i lecheniya voronkoobraznoy deformatsii grudnoy kletki u detey. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii. 2015;(1):40−46. (In Russ.)

[187] Brian GA, Millspaugh DL, Desai AA, et al. Pectus excavatum: benefit of randomization. J Pediatric Surg. 2015;50(11):1937–1939. DOI: 10.1016/j.jpedsurg.2015.05.009

[188] Brian G.A., Millspaugh D.L., Desai A.A., et al. Pectus excavatum: benefit of randomization // J. Pediatric. Surg. 2015. Vol. 50. No. 11. P. 1937–1939. DOI: 10.1016/j.jpedsurg.2015.05.009

[189] Brian GA, Millspaugh DL, Desai AA, et al. Pectus excavatum: benefit of randomization. J Pediatric Surg. 2015;50(11):1937–1939. DOI: 10.1016/j.jpedsurg.2015.05.009

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Dolgiev BH, Ryzhikov DV, Vissarionov SV