Experience of the Wang procedure in treating pectus excavatum in two hundred fifty-six paediatric patients

Introduction To analyze and summarize the orthopaedic effect and application experience of the Wang procedure in the treatment of pectus excavatum in paediatric patients. Methods The clinical data of 256 children ranging from 0.83~14 years (4.89±2.83 years) who underwent the Wang procedure for pectus excavatum from January 2017 to September 2020 in our hospital were analyzed retrospectively. A 1~2-cm incision was made in front of the xiphoid, and a tunnel was constructed on the deep surface of the thoracic cage. Steel wires were inserted through the bilateral costal arch and the lower sternum, and a steel bar was placed in the tunnel. The wires were pulled taut and fixed to the bar, and the incision was sutured. Results All the procedures were performed using one steel bar. The range of the procedure duration, the intra-operative bleeding volume, and the hospitalization stays of the patients were 18 to 45 (24.02±4.89) minutes, one to ten (2.16±1.68) mL, and three to nine days (5.71±1.35 days) respectively. Post-operative pneumothorax occurred in three cases without other complications. All the cases received follow-up for one to 45 months after discharge, during which six cases experienced poor wound healing, removed steel plate in 82 cases, and three cases of pectus excavatum recurrence. Conclusions The Wang procedure is a good option for treating pectus excavatum, secondary pectus excavatum, or recurrent pectus excavatum in paediatric patients.