Table 8 Recommendations for thoracic surgery

R8.38

Respiratory symptoms are not common in PS patients. Lack of protection of lungs and other thoracic organs due to the rib cage defect (rib agenesis) does not indicate per se thoracoplasty during childhood.

Definitely useful/strong literature

R8.39

It is better to avoid non resorbable materials before 12 years of age.

Possibly useful/modest literature

R8.40

Conservative methods (vacuum bell, FMF or corset for pectus carinatum) are promising tools to treat pectus excavatum and carinatum associated with PS in young patients.

Definitely useful/strong literature

R8.41

The management of pectus excavatum and pectus carinatum should be evaluated for each case and can be carried out through conservative strategies (vacuum bell, braces) or interventional ones (Nuss procedure, surgical treatment of pectus carinatum), although surgery in absence of respiratory symptoms should be postponed at least until the beginning of adolescence, towards the completion of the growth of the thoracic wall

Definitely useful/strong literature

R8.42

PS can be classified in minimal (only pectoral defect), partial (thoracic or upper arm variant) and complete form

Definitely useful/strong literature

R8.43

TBN classification is useful to classify the thoracic defect in PS

Definitely useful/strong literature

R8.44

Early evaluations of patients optimizes the treatment and is better for psychological reasons.

Possibly useful/modest literature

R8.45

In selected cases, 3D Printing and new technologies can be helpful to build prosteses custom made for thoracic reconstruction in PS

Definitely useful/strong literature

R8.46

Combined surgical treatment (thoracic and plastic surgery) can reduce the number of surgical procedures.

Definitely useful/strong literature