Objective To evaluate the short-term efficacy and safety of a modified Nuss procedure utilizing a pre-shaped bar with T-shaped ends and an intercostal fixation (rib-locking) technique for the repair of pectus excavatum in adults. Methods A retrospective analysis was conducted on the clinical data of 166 patients with chest wall deformities who underwent surgical treatment at our center between August 2020 and May 2023. Preoperative and postoperative Haller indices were compared. Operative time, length of hospital stay, and perioperative complications were recorded. Follow-up was conducted at 3 months, 1 year, 2 years, and 3 years postoperatively to assess satisfaction with chest wall appearance and quality of life. Results The median operative time was 35 (range: 30-45) min, and the median length of hospital stay was 4 (3-5) days. All patients were discharged after recovery, with no perioperative mortality. The median Haller index decreased from 4.3 (3.6-5.1) preoperatively to 2.9 ( 2.6-3.1) postoperatively. Only 2 patients (1.2%) required thoracic drainage due to pneumothorax or pleural effusion. Bar displacement occurred in 1 patient (0.6%), which was managed by re-operation 2 months postoperatively. At 2 and 3 years postoperatively, >98% of patients remained "very satisfied" with the cosmetic results. All followed-up patients reported their quality of life as "better" or "much better" after the minimally invasive repair of pectus excavatum. Conclusions The modified procedure can achieve satisfactory correction in adult pectus excavatum with a low incidence of complications and bar displacement. It possesses clinical application value, though further validation through multicenter prospective studies is warranted.
