Propensity-matched comparative analysis of the Wang and Nuss procedures for pediatric pectus excavatum: a single center retrospective cohort study

Objective: To compare the safety and efficacy of the Wang and Nuss procedures in pediatric patients undergoing surgical correction for pectus excavatum. Methods: This retrospective cohort study included 69 patients with pectus excavatum treated at a single center between January 2013 and August 2021. After applying strict inclusion and exclusion criteria, patients were stratified into two groups based on the surgical approach: the Nuss group ( n = 38) and the Wang group ( n = 15), following 1:3 propensity score matching to ensure baseline comparability. Perioperative data including demographics, surgical parameters, and postoperative outcomes were collected and analyzed. Results: Both procedures resulted in satisfactory cosmetic and functional outcomes with no operative or perioperative deaths. Baseline characteristics such as age, sex, Haller index, and comorbidities were well balanced between the two groups. Compared with the Nuss group, the Wang procedure demonstrated significantly shorter operative time (56.0 ± 24.2 vs. 109.7 ± 30.3 min, P < 0.001), lower postoperative pain scores (4.0 ± 0.76 vs. 5.34 ± 1.65, P < 0.001), and reduced hospital stay (3.67 ± 0.97 vs. 5.89 ± 3.18 days, P = 0.01). Although intraoperative blood loss was lower in the Wang group, the difference was not statistically significant ( P = 0.28). Complication rates and patient satisfaction scores were comparable. Conclusion: Wang procedure showed promising short-term results, but evidence is limited due to small sample size and short follow-up.