Patient selection: pectus excavatum
Reasons for reoperation:
(1) bar migration
(2) recurrence after bar removal
(3) reactive pectus excavatum
Reoperation is reduced with:
(1) a surgeon experienced in MIRPE
(2) use of thoracoscopic guidance
(3) use bilateral pericostal fixation
(4) not using a bar stabilizer
(5) not using wire fixation
The patient should be monitored postoperatively for:
(1) bar migration (usually occurs in early postoperative period)
(2) reactive pectus carinatum (rare)
Recurrence of pectus is reduced if elective bar removal is performed when both criteria are met:
(1) The patient is >= 18 years of age.
(2) The bar has been in place for >= 4 years.
