Pectus excavatum

Pectus excavatum (PE) is the most common chest wall deformity and usually presents early during development and reaches its maximum severity during puberty. Most of the patients with PE are not symptomatic and complain of their altered visualization of the anterior chest wall. A minority of patients presents with respiratory or cardiac symptoms or abnormal pulmonary or heart function tests. Physical examination is the most appropriate tool to assess the indication for surgical repair, although every patient usually undergoes cardiac and pulmonary imaging studies. An open and a minimally invasive (MI) repair are acceptable options for the surgical correction of pectus excavatum. Both display excellent short- and long-term results. The improved cosmetic results and the earlier discharge from the hospital have recently popularized the MI approach (Nuss technique). Surgical correction of PE is safe and accepted provided that it is performed in thoracic surgical centers that can handle all the pre-, intra- and postoperative issues related to the disease with a multidisciplinary approach.