Does a child's pectus excavatum require surgery?

Children with pectus excavatum do not necessarily need surgery. Whether surgery is needed should be determined based on the severity of the pectus excavatum, the specific impact on the child's health, and the doctor's evaluation results. Mild pectus excavatum usually does not require surgical intervention, while severe pectus excavatum may require surgical correction to improve the chest abnormality.

1. What is pectus excavatum?

Pectus excavatum is a congenital chest abnormality characterized by the inward depression of the sternum, forming a funnel-shaped shape. It is more common in boys than girls. Most cases of pectus excavatum can be detected after birth, but may gradually worsen as the child grows and develops, especially during puberty when the symptoms may be more obvious. Mild pectus excavatum is usually harmless to health and is mainly a cosmetic problem; severe pectus excavatum may cause compression of the heart and lungs, thereby affecting heart and lung function.

2. Health impacts caused by pectus excavatum

Mild pectus excavatum will not significantly affect your child's daily life, but severe pectus excavatum may cause:

Cardiopulmonary compression: A retracted sternum may compress the heart and lungs, causing symptoms such as shortness of breath, chest tightness, and fatigue after activity.

Psychological problems: Children may develop inferiority complex due to abnormal breast appearance, which may affect their social and mental health.

Reduced exercise capacity: Impaired cardiopulmonary function can limit a child’s ability to exercise and affect the quality of their daily activities.

3. How to determine whether surgery is needed?

Whether surgery is needed depends mainly on the following factors:

Degree of deformity: Mild pectus excavatum can be managed by observation and regular follow-up without treatment, while severe pectus excavatum is significantly inward-facing and cardiopulmonary function is affected, usually requiring intervention. The severity is usually assessed by the Haller index of the chest on CT scans. If the index exceeds 3.25, surgical intervention is usually recommended.

Symptoms: Surgery is recommended if your child has symptoms such as chest tightness, shortness of breath, frequent fatigue, or limited mobility.

4. What are the treatments for pectus excavatum?

Surgery

Nuss surgery: The most commonly used minimally invasive surgery, the doctor will implant a metal stent under the chest to correct the sternum retraction. The stent needs to be retained for 2-3 years before removal. This method is less invasive and has a quick recovery.

Ravitch surgery: A traditional surgical method that requires the removal of deformed cartilage and reshaping of the sternum. It is relatively traumatic and is mostly used in complex cases.

Emerging technologies: For example, 3D printing-assisted surgery can customize surgical plans for special individuals and improve results.

Nonsurgical treatment

External stent treatment: Mild pectus excavatum can be corrected to a certain extent by wearing a corrective brace such as a suction cup corrector, which uses external force to improve the shape of the chest.

Breathing training and exercise: Exercising the respiratory muscles and increasing chest flexibility, such as swimming and yoga, can help improve appearance and function.

5. What should parents pay attention to?

Parents should follow up with their children regularly to monitor chest shape and cardiopulmonary function to determine changes in the condition. In family life, help children build self-confidence, avoid excessive attention to appearance issues, and seek mental health support when necessary.

Whether a child with pectus excavatum needs surgery should be determined based on medical judgment and individual needs. If a child has severe symptoms or obvious deformities, it is recommended that you consult a professional in a timely manner to choose a reasonable treatment plan to improve the quality of life.