Generally, PE can be corrected with either the Wang procedure or the Nuss procedure.If the risks and difficulties of the surgery are not taken into account, both surgical methods can achieve similar correction effects. However, for certain special types of PE, the Wang procedure might be the only reasonable option. These special types encompass:

1. Asymmetric PE：This deformity is essentially equivalent to a type of complex chest wall deformities, and the classic Nuss procedure and the bars used in the surgery cannot correct this deformity well. The Wang procedure can correct this deformity very well due to its different techniques and principles.

   
   

2. PE with acute angular deformity：When the concavity is extremely severe, sharp angles may form at its edges or base. Such deformities signify highly concentrated stress in the concave area. Attempting to elevate the concavity directly with bars, as in Nuss procedure, can easily deform the bars or even lead to bone fractures. To disperse the local stress as much as possible, Wang procedure initially employs different surgical instruments and methods to lift the bones in the concave area to an appropriate height, facilitating smoother subsequent correction.

   
   

3. PE that still existed after failed Nuss procedure or Ravitch procedure: Chest wall surgeries can cause severe adhesions on the surface of the heart, posing significant obstacles and difficulties for the secondery surgery. If the Nuss procedure is performed in the secondary surgery, the adhesions can hinder the placement of the bars, increasing the risk of cardiac injury. Conversely, Wang procedure, where the bar is not implanted into the chest cavity but rather placed on the surface of the depressed chest wall to achieve correction, poses no risk of cardiac damage.

   
   

4. PE that requires simultaneous cardiac surgery: Since cardiac surgeries typically necessitate an incision in the mid-anterior chest wall, which coincides with the surgical approach of Wang surgery, it helps minimize additional surgical trauma. In contrast, performing Nuss surgery with additional incisions in the lateral chest wall would significantly increase the patient's surgical burden and potential complication risks.

   
   

5. Secondary PE after cardiac surgery: Cardiac surgery often leads to extensive adhesions around the heart, which greatly increases the risk of heart damage during the Nuss procedure. In contrast, Wang procedure is performed outside the chest cavity, so it can effectively avoid this risk and provide patients with a safer treatment plan.

   
   

6. Extremely severe PE: For cases of extremely severe PE, the space between the chest wall and the heart is extremely compressed, making it impossible to place and flip the bars in the chest cavity, thus failing to meet the basic conditions for performing the Nuss procedure. In this extreme case, Wang procedure, with its unique surgical principles and techniques, has become the only feasible surgical method, bringing hope to the patients.