Letter to Editor

Pectus Surgery

Murat Oncel1*, Guven Sadi Sunam1 and Huseyin Yildiran2
1Department of Thoracic Surgery, Selcuk University Medical Faculty, Turkey
2Department of Thoracic Surgery, Konya Numune Hospital, Turkey

*Corresponding author: Murat Oncel, Department of Thoracic Surgery, Selcuk University Medical Faculty, Alaeddin Keykubat Kampüsü, 42000, Konya, Turkey

Published: 06 Dec, 2017
Cite this article as: Oncel M, Sunam GS, Yildiran H. Pectus Surgery. Clin Surg. 2017; 2: 1807.


Pectus excavatum; Surgery

Letter to Editor

We read the article that was written by Shaalan and colleagues with interest [1]. We started the minimally invasive procedure for pectussurgery in 2011. We still use the Ravitch technique as an advantageous procedure if it is necessary for older patients, mix type deformities. Nuss procedure decreases the severe bleeding, the hospitalization time and pain for pectus excavatum. The short skin incision without cartilage resection provides great aesthetic results. We also use the Haller index, pulmonary fuction tests and echocardiography in preoperative preparation period as stated in the article [1]. However we experienced this tests could not give adequate information about cardiac pressure and efficacy in many patients, so we described that the right ventricule compression and myocardial perfussion index via tissue doppler echocardiography specifically in our clinic [2]. Additionally we presented the postoperative effects on respiratory muscle strength by the measurements of Maximum İnspiratory Pressures (MIP) and Maximum Expiratory Pressures (MEP) [3]. Nuss procedure is an excellent technique with thoracoscopy and the cardiac injury as a terrible complication is not seen when the operation performed by experienced surgeons. We use short skin incision and after the resection of cartilages we use them again to protect the cartilaged efect in open surgery and modified Ravitch procedures.
Although Ravitch technique is still in some cases if it is necessary, but minimally invasive surgery is a mile stone in pectus surgery according to satisfaction and cost of efficacy.


  1. Shaalan AM, Kasb I, Elwakeel EE, Elkamali YA. Outcome of surgical repair of Pectus Excavatum in adults. J Cardiothorac Surg. 2017;12:72.
  2. Cimen D, Murat O, Arslan D, Guven SS, Oran B. The effects of surgical operation on cardiac functions of people with pectus excavatum who have right ventricular pressure. Prim Res Med. 2015;4(1):165-9.
  3. Oncel M, Tulek B, Sunam GS, Yildiran H. Effects of Nuss Procedure on Respiratory Muscle Strength. Short Oral Communication presented at the 18th CWIG (Chest Wall International Group) Annual Meeting, 2017 June 14-16, Florence, Italy.