The surgical treatment of pectus excavatum: an experience with 90 operations.

Funnel chest, a congenital hereditary deformity, may lead to impairment of cardiopulmonary function. The predominant motives for operation are psychological and cosmetic. Patients with minor deformities amenable to physiotherapy should not be operated upon, but moderately severe defects justify surgical intervention. Objective photographic documentation is essential. Because of their importance to surgical technique and results, the symmetrical, asymmetrical, localized, and extensive deformities should be distinguished. Ninety operations were performed between 1951 and 1974 according to the various techniques known during that period. Results were irregular until the introduction eight years ago of an operation combining extensive resection according to Ravitch and stabilization by a metal strut as recommended by Adkins and others. Of 24 operations performed during the last eight years, 23 have given excellent long-term results.