USE OF THE CORRECTION INDEX AND SURGICAL OUTCOMES IN MINIMALLY INVASIVE REPAIR OF PECTUS EXCAVATUM (MIRPE) IN CHILDREN

43. Ulusal Çocuk Cerrahisi kongresi ve Mısır Çocuk Cerrahisi ortak kongresi, İstanbul, Türkiye, 21 - 24 Ekim 2026, ss.135-136, (Özet Bildiri)

Aim: Pectus excavatum is the most common congenital chest wall deformity in childhood. Although the Haller Index

has long been used to determine surgical candidacy, the Correction Index (CI) has gained increasing acceptance. A CI

≥28% is considered an appropriate indication for minimally invasive repair of pectus excavatum (MIRPE). This study

evaluated deformity severity, bar number, postoperative analgesia, and preoperative cardiopulmonary assessment in

patients undergoing MIRPE.

Methods: Patients who underwent MIRPE were retrospectively reviewed. A total of 126 patients with available

preoperative thoracic computed tomography scans were included. Demographic characteristics, CI values, analgesic

techniques, number of bars, and echocardiographic (ECHO) and pulmonary function test (PFT) findings were analyzed.

The recommended 28% CI threshold was used as the reference.

Results: The mean age was 14.43 ± 2.29 years; 24 patients (19.1%) were female and 102 (80.9%) were male. Mean CI

was 38.9 ± 8.6%. A CI ≥28% was present in 117 patients (92.8%) and <28% in 9 (7.1%). Echocardiography demonstrated

cardiac abnormalities in 83 patients (65.9%), most commonly mitral valve prolapse and mild mitral regurgitation. PFTs

were normal in 91 patients (72.7%), showed restrictive ventilatory impairment in 15 (11.4%) and isolated FEV₁ reduction

in 3 (2.3%); results were unavailable in 17 (13.4%). Postoperative analgesia consisted of intravenous multimodal

analgesia in 114 patients (90.5%) and epidural analgesia in 12 (9.5%). Despite CI ≥28%, a single bar was sufficient in

118 patients (93.6%), whereas only 8 (6.4%) required two bars.

Conclusions: Overall, 92.8% met the CI-based criteria for surgery. MIRPE may also be considered in selected patients

with CI <28% and significant cardiac, respiratory, or cosmetic concerns. In children, thoracic anatomy and chest wall

flexibility allow satisfactory correction with a single bar in most cases.