Early Consequences of Pectus Excavatum Surgery on Self‐Esteem and General Quality of Life

Abstract

BackgroundAn early observation after chest wall correction is direct inspection from the PE patient of their “new” thorax. Changes in self-perception may give raise to other psychological adaptations. The aim of this study was to evaluate the early changes in the fields of self-esteem, body image and QoL.MethodsProspective observational longitudinal multicenter cohort study. Self-esteem, emotional limitations and general health were assessed using the Child Health Questionnaire (CHQ) in patients under 18 and the World Health Organization Quality of Life Questionnaire-bref (WHOQOL-bref) was used for body image, psychological domain and overall QoL in patients over 16 years of age. Measurements were taken before surgery (T1) and 6 weeks (T2), and 6 months thereafter (T3).ResultsScores on post-operative self-esteem were significantly higher compared with scores pre-operatively (p < 0.007). Also body image, psychological domain and emotional limitations showed significant improvement, respectively p < 0.001, p < 0.001, and p < 0.016. Significant improvement in the first three components was mainly achieved in the first 6 weeks post-operative. In emotional limitation, however, the largest change was between 6 weeks and 6 months. Overall quality of life in the WHOQOL-bref and general health domain in the CHQ showed no significant improvement in relation to the pre-operative scores.ConclusionPost-operative PE patients after Nuss procedure showed an improved body image, increased self-esteem and increased psychological resilience in the first 6 months, with the most marked change in the first 6 weeks. Also emotional limitations changed significantly over time. The changes were not large enough to influence general QoL or general health significantly.

Surgery for Deformities of the Thoracic Wall: No More than Strengthening the Patient's Self-Esteem?

“…[13][14][15] A new multicenter study from the Netherlands showed improved body image, increased self-esteem, and increased psychological resilience after MIRPE, with the most marked change reported in the first 6 weeks after surgery. 8 Steinmann et al included in their prospective study patients with PE and PC who underwent surgical correction and found among this group a highly disturbed preoperative body image with reduced mental QoL and low self-esteem that differed significantly from the control group. 1 The literature for QoL following correction of PC remains limited.…”

“…Postoperatively, many studies showed significantly improved body image and self-esteem among patients, which has a substantial impact on their QoL. [1][2][3][4][5][6][7][8] In this review, we evaluate all published studies on body image, self-esteem, or QoL in patients with pectus excavatum (PE) and pectus carinatum (PC).…”

The Regional Analgesia Methods After the Nuss Procedure for Repair of Pectus Excavatum

“…Голландські автори успішно застосовували як пацієнт-контрольовану епідуральну аналгезію, так і пацієнт-контрольовану внутрішньовенну аналгезію морфіном, інколи з додаванням кетаміну у пацієнтів з ЛДГК після корекції за Nuss протягом перших трьох діб після операції, з подальшим переходом на пероральний прийом аналгетиків [13].…”

Trends in the Treatment of Pectus Excavatum in the Netherlands

“…Patients with a PE show a lower self-esteem compared with their peers influencing their development during adolescence and thereafter. 2 Physical complaints, such as localized rib or sternum pains, may also influence their social behavior. Unfortunately, Introduction Pectus excavatum (PE) is the most common deformity of the anterior chest wall and can be corrected surgically with different techniques.…”