{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:49:12Z","timestamp":1777736952009,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2007,1,1]],"date-time":"2007-01-01T00:00:00Z","timestamp":1167609600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2007,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The multiple-momentum (MM) based multitarget (MT) approach has been developed through a single surgeon's experience to overcome the limits of the conventional Nuss procedure, which is the single target-single momentum approach that corrects only symmetric pectus excavatum (PE). The new techniques that have been devised on a morphologic basis, according to the Terrain Contour Matching (TERCOM) system, have made this approach a comprehensive one that can cover all types of pectus deformity. The aim of this study was to elucidate the difference between the conventional technique and the new approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The data of 630 PE patients who received the modified Nuss procedure, based on the MM-MT-TERCOM approach, between 1999 and 2005, were retrospectively studied. The conceptual differences between the new approach and the conventional one were determined. The techniques according to a new paradigm, for treating asymmetry, adults, and complex morphology, as well as the bar fixation technique, were analyzed. The results of the repair were assessed with a new CT index, the Asymmetry Index (AI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>According to the morphologic classification, 269 patients were asymmetric (42.7%): 138 were eccentric (53 Grand Canyon type), 88 were unbalanced, and 36 were combined. On the basis of the MM-MT-TERCOM concept for repairing complex morphology, multiple targets were selected in 224 patients (35.6%). To correct targets simultaneously, positive momentum (630 patients, 100%) and negative momentum (124 patients, 19.7%) were applied as appropriate. The techniques used were an asymmetric bar (250 patients, 39.7%), a seagull bar (107 patients, 17%), a complex bar via TERCOM (126 patients, 20%), the crest compression technique (59 patients, 9.4%), and a compound bar (84 patients, 13.3%). The postoperative changes of the AI were from 1.03 \u00b1 0.06 to 1.02 \u00b1 0.13 (P = 0.117) in the symmetric group and they were from 1.1 \u00b1 0.05 to 1.02 \u00b1 0.02 (P &lt; 0.001) in the asymmetric group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Refinement of techniques in accordance with the morphology and cause-effect basis of the bar action provided reproducible results for achieving postrepair symmetry for treating complex PE. Therefore, the new approach with techniques that use multiple momentums (MM-MT-TERCOM) supports the new paradigm of the Nuss procedure is effective in repair of all morphologic types of PE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/imi.0b013e3180313a19","type":"journal-article","created":{"date-parts":[[2008,5,5]],"date-time":"2008-05-05T04:13:59Z","timestamp":1209960839000},"page":"25-28","source":"Crossref","is-referenced-by-count":12,"title":["Technical Innovations in the Minimally Invasive Approach for Treating Pectus Excavatum: A Paradigm Shift through Six Years\u2019 Experience with 630 Patients"],"prefix":"10.1177","volume":"2","author":[{"given":"Hyung Joo","family":"Park","sequence":"first","affiliation":[{"name":"Korea University Medical Center, Ansan Hospital, Ansan, South Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2007,1,1]]},"reference":[{"key":"bibr1-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(98)90314-1"},{"key":"bibr2-imi.0b013e3180313a19","first-page":"355","volume-title":"Surgery of the Chest.","author":"Shamberger R.C.","year":"2005"},{"key":"bibr3-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2003.11.012"},{"key":"bibr4-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-34486"},{"key":"bibr5-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2005.03402.x"},{"key":"bibr6-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.01.046"},{"key":"bibr7-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)01330-4"},{"key":"bibr8-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1016\/S0012-3692(16)46588-8"},{"key":"bibr9-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(00)90018-6"},{"key":"bibr10-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(00)90019-8"},{"key":"bibr11-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2001.20707"},{"key":"bibr12-imi.0b013e3180313a19","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-34485"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1097\/imi.0b013e3180313a19","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1097\/imi.0b013e3180313a19","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:17:40Z","timestamp":1777461460000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1097\/imi.0b013e3180313a19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,1]]}},"alternative-id":["10.1097\/imi.0b013e3180313a19"],"URL":"https:\/\/doi.org\/10.1097\/imi.0b013e3180313a19","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1]]}}}