Cardiorespiratory Function after Operation for Pectus Excavatum

Objective: We performed a review of current data to determine the effect that operation has on pulmonary function, aerobic capacity, and stroke volume in patients with pectus excavatum. Study design: Two reviewers independently assessed clinical trials and collected data on interventions and outcomes. To qualify for inclusion, a study had to include preoperative and postoperative assessment, provide outcomes in either a published percentile or qualified matched control form to control for interval growth, and include only original patient groups. Results: Postoperative total lung capacity for patients who had Ravitch repair was significantly lower (SMD, 0.71 [CI -1.06, -0.36]; I² = 19.6%) than preoperative. Based on 2 studies after removal of the Nuss bar, FEV₁ was significantly increased from preoperative values (SMD, 0.39 [CI, 0.03, 0.74]; I² = 0%). Stroke volume increased after surgery (SMD, 0.40 [CI, 0.10, 0.70]; I² = 0%) after Ravitch repair. There was a trend toward improved exercise tolerance, but it was not statistically significant. Conclusions: Total lung capacity was decreased after Ravitch repair, and FEV₁ was increased after Nuss bar removal. Stroke volume may be increased after Ravitch repair. Exercise tolerance was not improved after either type of surgical repair.