Quality of life improves after minimally invasive repair of pectus excavatum

Kuru, Pinar; Bostancı, Korkut; Ermerak, Nezih Onur; Bahadir, A. Tugba; Afacan, Ceyda; Yüksel, Mustafa

doi:10.1177/0218492314553442

Cited by 39 publications

(39 citation statements)

References 21 publications

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“…Thus, along with previous prospective studies (15,(18)(19)(20)(21), this study highlights the positive effects that the PE correction can have on the patients and their families. The parents reported a reduction in their own level of distress due to the child's condition as well as increased family cohesion following surgery.…”

Section: Discussionsupporting

confidence: 75%

“…Previous research has shown that PE correction does have a positive impact on the patients' disease-specific HRQL (15,(18)(19)(20)(21). In particular, the use of disease-specific measures increases the likelihood of showing the effect of PE correction (22,23).…”

Section: Discussionmentioning

confidence: 99%

“…Improvement in physical symptoms, increased body image satisfaction, and decreased negative feelings, such as frustration, sadness, and negative social experiences, have been reported in studies, which have all utilized a prospective design and PE-specific measures (15,(18)(19)(20)(21). In general, disease-specific measures focus on those dimensions that are likely to be affected by a treatment and are more sensitive to treatment-related changes.…”

Section: Introductionmentioning

confidence: 94%

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

Lomholt

Jacobsen²,

Thastum

et al. 2016

Ann. Cardiothorac. Surg.

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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.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

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

Lomholt

Jacobsen²,

Thastum

et al. 2016

Ann. Cardiothorac. Surg.

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“…2,[8][9][10] In addition, recent studies have suggested that minimal invasive repair of PE improves the quality of life, body image, and the patient's self-esteem. 15,16,[18][19][20] To engage in light physical exercise such as jogging and cycling slowly according to his pace Patient's information: A 12-year-old boy with his parents visited our department's pediatric cardiac and thoracic outpatient clinic at the province city hospital in the background of severe recurrent chest pain accompanied by chest tightness. The patient was tall, thin with clear consciousness denied any trauma to the chest and was also not on any medications and at the time of visit he was not in any acute distress what so ever.…”

Section: Introductionmentioning

confidence: 99%

Pectus excavactum-insights into its diagnosis and the current treatment options along with its clinical outcomes: two case reports

et al. 2018

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Pectus excavatum (PE) is a congenital sternal depression, one of the most frequent major congenital malformations of the chest wall. Generally, the malformation is not associated with functional disorders and often constitutes an aesthetic alteration with significant psychological distress. Nevertheless, the surgical repair of PE in childhood has been a well-established procedure with modified Ravitch repair (MRR) and minimally invasive repair (MIR) by Nuss been the two most popular methods of corrections. As a means of concealing the ugly skin scars caused by the MRR technique, the procedure was however highly modified with the use of bilateral inframammarian separated skin incisions. However, MIR has been a preferable technique due to its shorter operative time and minimal blood loss, but its postoperative complications have so far seemed to be its limiting factor whereas, extensive and combined deformities of the ventral chest wall are classically corrected using either MIR by Nuss and the MRR technique. Notwithstanding, Conservative treatment using alloplastic implants or vacuum bell to elevate the sternum in patients with mild PE defect is becoming a potential alternative and a means of preventing unnecessary surgical procedures mostly in mild funnel chest. Presented here is a case of PE surgical correction in a 12-year-old boy and an 11-year-old girl with pectus bar dislodgment. This article analyses the chain of events between both patients, reviews the literature on the subject and other currently available treatment options.

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“…Large incisions and scars limit this operation's satisfactory results. For more than 20 years, minimally invasive repair of pectus excavatum (MIRPE) has become a widely used technique in the clinical settings [6,7]. This technique, which is first described in 1987 by Dr. Donald Nuss, enables thoracic surgeons correcting these deformities with small bilateral incisions for using a retrosternal shaped bar inserted by a thoracoscope [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the internal thoracic artery blood flow before and after Nuss operation: is it reversible?

Kuru-Bektaşoğlu¹,

Ermerak²,

Çimşit³

et al. 2017

Marmara Medical Journal

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ÖZAmaç: Pektus ekskavatumun, Nuss barları ile minimal invaziv onarımında internal torasik arter (ITA) tıkanması literatürde bildirilmiştir. Bu çalışmada, ITA tıkanıklığının, Nuss bar takılmasından ve çıkarılmasından sonraki durumununun renkli Doppler ultrasonografi ile değerlendirilmesi amaçlanmıştır.Gereçler ve Yöntemler: Nuss bar operasyonu uygulanan 19 hasta çalışmaya prospektif olarak dahil edilmiştir. Renkli Doppler ultrasonografi ile Nuss bar takıldıktan sonra ve Nuss bar çıkartıldıktan sonra ITA akımı karşılaştırılmıştır. Hastalar cinsiyet, yaş, deformitenin simetrisi, Haller indeksi ve takılan bar sayısı açısından değerlendirilmiştir.Bulgular: Nuss bar operasyonu uygulanan 19 pektus ekskavatumlu hasta (17 erkek, 2 kadın, ortalama yaş: 21,78±6.35) çalışmaya alındı. Sekiz hastanın (%42,1) bar çekimi öncesi ve sonrası ITA akımı normal olarak değerlendirildi. Bar çekimi öncesi muayenede 6 hastada çift taraflı (n=2), ya da tek taraflı (n=4) ITA tıkanıklığı, ve 5 hastada çift taraflı (n=2), ya da tek taraflı (n=3) ITA akım bozukluğu tespit edildi. Bar çekildikten sonra etkilenen hastalardan (%57,9) sadece 2 hastada (%10) tıkanma devam etmekteydi. Dokuz hastada ITA kan akımı normal olarak değerlendirildi.Sonuç: Bar çıkartıldıktan sonra, ITA'lerin sadece %10'unda etkilenim devam etmekte idi.Anahtar kelimeler: Pektus ekskavatum, Göğüs duvarı deformiteleri, İnternal torasik arter, Pectus ekskavatumun minimal invaziv onarımı, Doppler ultrasonografi IntroductionPectus excavatum (PE) is characterized by depression of the sternum and costal cartilages (funnel-shaped chest wall) [1]. PE is the most common chest wall deformity which represents the 90% of all chest wall deformities and it has 0.1-0.8% incidence [2,3]. The classic surgical method for correction of PE is the Ravitch sternochondroplasty [4,5]. Large incisions and scars limit this operation's satisfactory results. For more than 20 years, minimally invasive repair ABSTRACT Objective: Obstruction of the internal thoracic arteries (ITAs) by the Nuss bars in minimally invasive repair of pectus excavatum (MIRPE) has been documented in the literature. In this study, we aim to investigate the patency of ITAs before and after repair of the pectus excavatum with the Nuss procedure, by using color Doppler ultrasonography (US). Materials and Methods:Nineteen patients who underwent Nuss procedure were included in this study prospectively. Color Doppler US examinations were performed for comparing ITA patency after insertion of the Nuss bars and after their removal. Patients were evaluated according to gender, age, symmetry of deformity, Haller index, and the number of Nuss bars inserted.Results: Nineteen patients operated with MIRPE (17 male and 2 females with a mean age 21.78±6.35) were enrolled in the study. Eight patients (42.1%) with normal ITA blood flow preoperatively had normal blood flow after removal of the bar. In preoperative examination, 6 patients had bilateral (n=2) or unilateral (n=4) obstruction of the ITA and 5 patients had bilateral (n=2) or unilateral...

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Quality of life improves after minimally invasive repair of pectus excavatum

Abstract: Minimally invasive repair of pectus excavatum significantly improved the physical and psychosocial wellbeing of patients. Longitudinal studies are needed to determine the long-term changes related to quality of life.

Cited by 39 publications

References 21 publications

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

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

Pectus excavactum-insights into its diagnosis and the current treatment options along with its clinical outcomes: two case reports

Evaluation of the internal thoracic artery blood flow before and after Nuss operation: is it reversible?

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