“When to Nuss? patient age as a risk factor for complications of minimally invasive repair of pectus excavatum: a systematic review and meta-analysis”
Topic overview
Systematic review of 5,978 patients demonstrates that older age at time of minimally invasive pectus excavatum repair (MIRPE) significantly increases complication risk, including pneumothorax, bar displacement, and need for reoperation. Findings support performing Nuss procedure before late adolescence to optimize outcomes.
Key takeaways
- Patients ≥18 years have 1.66× higher odds of MIRPE complications compared to younger patients (OR=1.66, 95% CI 1.28-2.14)
- Older patients face significantly higher rates of pneumothorax, pleural effusion, wound infection, bar displacement, and reoperations
- Meta-analysis of 5,978 patients showed overall 19.87% complication rate across all age groups undergoing MIRPE
- Evidence supports performing pectus excavatum repair before late adolescence to minimize complication risk
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