<b>Introduction:</b> Intercostal cryoablation has been widely adopted in many centers for the use during minimally invasive repair of pectus excavatum (MIRPE) due to its excellent postoperative pain control. However, there is a lack of studies comprehensively reviewing the scope and frequency of adverse effects after use of cryoanalgesia.<b>Methods:</b> We performed a systematic review of the literature from 2000 to June 2024 according to the PRISMA guidelines. The primary outcomes of interest were side effects and complications after use of cryoanalgesia during MIRPE procedure in children and adolescents.<b>Results:</b> An initial reference search yielded 1347 articles. Finally, after eligibility screening we chose 38 studies that we included in the further analysis. In our study, we demonstrated that the use of cryoanalgesia during Nuss procedure is reported to be associated with the risk of side effects. Although the risk of perioperative complications is low, possible problems include: loss of chest wall sensation, neuralgia, bar migration due to ignoring of activity restriction, dermatitis, lung injury and other.<b>Conclusions:</b> Despite the wide use of cryoanalgesia in pectus excavatum (PE) surgery in children and young adults, surgeon should be aware of possible side effects. This report is the first published study summarizing specific complications associated to use of intercostal cryoablation in PE surgery. In our opinion there is a substantial need for large randomized controlled studies in this topic.
Keywords: Nuss procedure; cryoanalgesia; funnel chest; intercostal cryoablation; pectus excavatum.