Patient Information
Pectus Excavatum
This leaflet has been written to provide information about surgery to correct a defect in the chest wall (Pectus excavatum /carinatum). We hope it answers some of the questions or concerns you may have. It is not intended to replace talking with medical or nursing staff.
What are Pectus excavatum / carinatum?
Pectus excavatum / carinatum are birth defects affecting the chest wall. In pectus excavatum the breastbone is depressed, causing a sunken appearance to the chest and in pectus carinatum the breastbone protrudes outwards.
What causes pectus excavatum / carinatum?
The defect is thought to be caused by excessive growth of cartilage, although the reason for this is unknown. This overgrowth causes the ribs and cartilages to ‘buckle’ and pushes the breastbone either inwards or outwards. The defect is often noticeable at birth but usually becomes more apparent in early adolescence and is more common in boys than girls.
How is it corrected?
It is sometimes possible to have surgery to correct the defect.
Surgery is performed under a general anaesthetic therefore you will be asleep during the procedure. Once you are asleep an incision is made in your chest and the defect is corrected by lifting and repairing the chest wall muscles and cartilages. It is sometimes necessary to turn the breast bone so it lies flat and insert a metal bar for support.
Often a small drain is inserted to drain any bleeding or fluid from the site and the wound closed using dissolvable stitches.
Will I feel any pain or discomfort after the procedure?
You may feel slightly uncomfortable after the procedure but you will be given medication to help control this. Alternatively you may be given a special pump to help control any pain or discomfort. The pump is attached to you by a small tube, usually in the back of your hand. You will be given a hand held button which delivers a measured amount of pain relieving medication through the tube each time you press it. You will be told how to use the pump if your doctor feels this is appropriate for you.
How long does it take?
The procedure usually takes approximately 3 hours
How do I prepare for the procedure?
You will usually come into hospital the day before the procedure. You may need to have blood tests, a chest x-ray, a heart tracing (ECG) and a breathing test. Staff on the ward will prepare you for theatre. You will be given an antiseptic wash to use to help prevent infection. You will be informed when to stop eating and drinking prior to your surgery.
Will it be successful?
This type of surgery is usually successful in correcting the defect. Your surgeon will discuss this with you in more detail before the procedure.
What are the benefits of having the procedure?
While many patients are able to accept and live happily with the shape of their chest others may lack in self confidence and have a negative self image. Corrective surgery may benefit these patients and improve their quality of life.
What are the risks involved?
As with any surgery there is a risk of complications.
There is a risk of infection to the incision site and a risk of bleeding.
There is also a risk of collapsing a lung (pneumothorax) during the procedure. If this happens you may require treatment to reinflate the lung.
Any risks involved with the surgery will be discussed with you in more detail before you sign a consent form.
What alternatives do I have?
This depends on the severity of the defect.
Many people choose to have no treatment for pectus excavatum / carinatum.
Your doctor would be happy to discuss any alternative treatments if they are applicable to you.
What can I expect after the procedure?
After the procedure you may be nursed on a high dependency unit for a day or so before returning to the ward. You will have your heart rate, blood pressure, oxygen level and wound site checked regularly. Any drains from the wound are usually removed within a few days. Staff will inform you when you are able to eat and drink.
If you have had a metal bar inserted it may be removed at a later date.
When can I resume normal activities?
You may be able to go home 5 – 7 days after your surgery. You will be given advice on how to care for the wound and what to do if you notice any redness, swelling or discharge. You should not drive for 6 weeks following surgery and you should take about 2 months off work. You must avoid any contact sports or heavy lifting for several months after the surgery to ensure all bones are healed. You will be reviewed as an outpatient after 6 weeks. This advice will be discussed in more detail before you go home.
For further information visit:
www.dipex.org
If you require a copy of this leaflet in any other language or format please contact us quoting the leaflet code and the language you require.
JCOV30/PALS
Publication date January 06
Review January 08