A prospective study on quality of life in youths after pectus excavatum correction

Abstract

Background: The impact of correction of pectus excavatum (PE) on adolescents' health-related quality of life (HRQL) has only been investigated in prospective designs using disease-specific measures and without controls. The aim of this prospective study was to evaluate the HRQL before and after surgical correction of PE using a generic HRQL measure, and to compare the reported level of HRQL before surgery with an age-comparable control group.Methods: Patients (n=107) and one of their parents (n=106) completed the generic HRQL measure: the Child Health Questionnaire before, 3 months, and 6 months after correction for PE. A control group (n=183) consisting of school children comparable in age completed the same measure on one occasion. Results:The patients' level of HRQL before surgery was comparable to the level of the controls except for physical functioning; here boys reported impaired function compared to controls (P<0.0001, d=0.72).Both patients and parents reported improved emotional wellbeing and self-esteem, as well as an increase in physical and social activities from pre-to post-surgery. These improvements were statistically significant (P≤0.001-0.03) and yielded moderate to high effect sizes (ƞ 2 =0.04-0.22). Conclusions:The improvement of physical and psychosocial HRQL reported by both patients and their parents as proxy indicates the psychological implications of the deformity. Patients reported impaired physical function compared to controls. Further, pre-surgery differences in HRQL between the patients and the controls were lacking. However, the improvement in the patients' HRQL following surgery may justify the correction of pectus excavatum. The effect of the deformity on patients wellbeing compared with controls' needs to be addressed in further studies.

Outcomes in adult pectus excavatum patients undergoing Nuss repair

“…In a 2016 study performed by Lomholt et al, 49 107 patients and 106 parents completed the generic health-related quality-of-life measure. The Child Health Questionnaire was assessed preoperatively and at 3, 6 months following PEx repair.…”

Deformities of the Thoracic Wall: Don't Forget the Plastic Surgeon

“…Such deformities despite successful functional or major morphologic repair still annoy the patients and sustainably interfere with their self-esteem. [5][6][7][8][9][10][11] Several surgical techniques in former times served for external remodeling of the anterior chest wall, prior to the advent of MIRPE. Out of them singular techniques such as the implantation of customized silastic or autologous tissue may nowadays still present alternative methods to fill up a funnel deformity, if patients decline thoracic wall support by metal bars, or in the presence of minor deformities, when thoracic wall elevation is estimated as overtreatment.…”

Modifications and Further Development of the Original Nuss Procedure: Blessing or Curse?

“…Now, 20 years after publication of the initial report, multiple centers have reported on the procedure from around the globe, and there is robust evidence of the operation's safety and efficacy. [4][5][6][7][8][9][10][11][12] For this report, the charge was to track the various modifications to the Nuss procedure, and to assess their value. There have been many such modifications: in 2015, 56 such published adaptations were reported at the 2014 Advanced Pectus Course in Phoenix.…”