Changes in Pulmonary Functions of Adolescents with Pectus Excavatum Throughout the Nuss Procedure

Background: We aimed to determine the longitudinal changes in pulmonary functions of adolescents with Pectus Excavatum who underwent the Nuss procedure, the minimally invasive repair of pectus excavatum (MIRPE).

Methods: Lung function measurements were performed before bar implantation (T₀), at least six weeks to ten months after implantation (T_1a), at least eleven months to sixty-one months after bar implantation (T_1b) and at least two weeks after bar explantation (T₂).

Results: Data of 114 patients (83.3% male) whose median age at implantation was 15.6 years and at explantation 18.7 years were analyzed. Shortly after implantation at T_1a a significant decline of vital capacity (VC; n = 82), forced vital capacity (FVC; n = 78) and forced expiratory volume in 1 second (FEV₁; n = 80) compared to T₀ was seen. At T_1b a significant decline for the residual volume (RV; n = 83), the residual volume/total lung capacity ratio (RV/TLC; n = 81), the total specific airway resistance (sRaw; n = 80) and the total airway resistance (Raw; n = 84) also compared to T₀ was measured. In the comparison of T_1b to T₂ a significant increase of VC, FVC (n = 67), FEV₁ (n = 69), TLC (n = 67) and a significant decrease of Raw (n = 66), sRaw, RV (n = 65) and the RV/TLC (n = 64) ratio could be observed. In the direct analysis between T₀ and T₂, after the explantation of the bar a significant increase in VC (n = 54), FVC (n = 52), and TLC (n = 55) and a significant decrease of RV (n = 51) and the RV/TLC index (n = 50), and in airway resistance parameters like Raw (n = 52) and sRaw (n = 51) could be detected.

Conclusions: Lung function values along with markers of airway resistance improve in patients after the complete procedure of MIRPE.

Level of evidence: Level II.