Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction

Steinmann, Cornelia; Krille, Stefanie; Mueller, Astrid; Weber, Peter G.; Reingruber, Bertram; Martin, Alexandra

doi:10.1016/j.ejcts.2011.02.019

Cited by 92 publications

(131 citation statements)

References 18 publications

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“…Similarly, Krasopoulos et al have reported a statistically significant improvement in the self-esteem of pectus deformity patients after having undergone reparative surgery (p = 0.001) [24]. Steinmann et al proposed that body image concerns may overshadow those of the presence of physical restrictions when ultimately deciding whether or not to repair pectus deformities, as patients' perceptions of their dysmorphia will ultimately influence the extent of satisfaction with treatment outcomes [25].…”

Section: Indications For the Treatment Of Pectus Deformitymentioning

confidence: 99%

Advances in the management of pectus deformities in children

Swergold¹,

Sridharan²,

Loukas³

et al. 2013

OJPed

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Pectus excavatum (PE) and pectus carinatum (PC) are relatively common deformities involving the anterior chest wall, occurring in 1:1000 and 1:1500 live births, respectively. While the etiology remains an enigma, the association of pectus deformities with other skeletal abnormalities suggests that connective tissue disease may play a role in their pathogenesis. Clinical features of these deformities vary with severity, as determined by the Haller index and Backer ratio, but frequently include cardiac and respiratory abnormalities. Importantly, there exist profound psychosocial implications for children afflicted with these deformities, including but not limited to feelings of embarrassment and maladaptive social behaviors. These debilitating characteristics have prompted the development of novel medical and surgical corrective techniques. The correction of pectus deformities reduces the incidence of physiological complications secondary to chest wall malformation, while simultaneously improving body image and psychosocial development in the affected pediatric population. The Ravitch (open) and Nuss (minimally invasive) procedures remain the most frequently employed methods of pectus deformity repair, with no difference in overall complication rates, though individual complication rates vary with treatment. The Nuss procedure is associated with a higher rate of recurrence due to bar migration, hemothorax, and pneumothorax. Postoperative pain management is markedly more difficult in patients who have undergone Nuss repair. Patients undergoing the Ravitch procedure require less postoperative analgesia, but have longer operation times and a larger surgical scar. The cosmetic results of the Nuss procedure and its minimally invasive nature make it preferable to the Ravitch repair. Newer treatment modalities, including the vacuum bell, magnetic mini-mover procedure (3MP), and dynamic compression bracing (DCB) appear promising, and may ultimately provide effective methods of noninvasive repair. However, these modalities suffer from a lack of extensive published evidence, and the limited number of studies currently published fail to adequately define their long-term effectiveness.

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Section: Indications For the Treatment Of Pectus Deformitymentioning

confidence: 99%

Advances in the management of pectus deformities in children

Swergold¹,

Sridharan²,

Loukas³

et al. 2013

OJPed

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“…В этот период за несколько месяцев в связи с ро-стовым скачком минимальный ранее косметиче-ский дефект становится грубым и уродующим [2], что может сильно повлиять на всю последующую жизнь. Именно поэтому в настоящее время показа-ниями к оперативному лечению являются не только функциональные изменения со стороны сердечно-сосудистой и дыхательной систем, но и грубый кос-метический дефект, который существенно влияет на качество жизни пациента [1,13,14,16,17].…”

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Emotional aspects of self-attitude of adolescents with Pectus excavatum (PE) before and after surgery (pilot study)

et al. 2017

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The present study deals with preliminary assessment of adolescents’ with Pectus excavatus (PE) personal emotional characters of selt-attitude prior to and after surgical treatment. PE is a congenital defect manifesting in retraction of sternum and cartilaginous portions of the ribs into the rib-cage. It constitutes about 90% of the entire number of cases of congenital pathology of the chest, its rate as high as 1-8 per 1000 neonates. The only method of treatment for this pathology is surgical operation for conservative measures can’t stop progressive deformation of the chest. The peak of this pathology coincides with adolescent period which is particularly sensitive for forming of personality. The goal of the present study is the assessment of emotional and personality features of adolescents with PE that are manifesting in peculiarities of cognitive, affective and behavioral reactivity. 26 adolescent patients aged 13 to 17 years with PE hospitalized at surgical clinic of St. Petersburg State Pediatric Medical University for subsequent primary operative elimination of this defect or recurring operation – ablation of the implant (1-4 years after the primary surgery) took part in the present study. High level of anxiety and depression associated with negative perception of their bodies prior to surgery was revealed. Urgent need for psychological assistance of these adolescents is evident as well as extension of further studies associated with peculiarities of emotional self-perception and its correlation with children-parents relationship character.

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“…PE may also impair restrict chest wall movement and impair cardiorespiratory function (3)(4)(5). Patients report symptoms related to the deformity as exercise intolerance, shortness of breath, and weakness (2,6,7). Previously, it has been stated that the deformity did not cause physiological dysfunction (1,2).…”

Section: Introductionmentioning

confidence: 99%

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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Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction

Cited by 92 publications

References 18 publications

Advances in the management of pectus deformities in children

Advances in the management of pectus deformities in children

Emotional aspects of self-attitude of adolescents with Pectus excavatum (PE) before and after surgery (pilot study)

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

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