Surgical Repair of Pectus Excavatum Markedly Improves Body Image and Perceived Ability for Physical Activity: Multicenter Study

Abstract

Surgical repair of pectus excavatum can significantly improve the body image difficulties and limitations on physical activity experienced by patients. These results should prompt physicians to consider the physiologic and psychological implications of pectus excavatum just as they would any other physical deformity known to have such consequences.

Multicenter Study of Pectus Excavatum, Final Report: Complications, Static/Exercise Pulmonary Function, and Anatomic Outcomes

“…The methods of assessing pain separately in children 8 to 21 years of age and a parent for the first 30 days post operation have been reported. 2 Patients were followed via phone, mail, or clinical visit at yearly intervals, on or near the anniversary of their surgery, for a period of up to 5 years for complications.…”

Advances in the management of pectus deformities in children

“…There is currently no data evaluating the effects of regular psychiatric followup with a psychiatrist on alleviating the psychological burden of poor body image in this patient group. Nevertheless, the lack of correlation between the anatomic severity of the deformity on CT and the physical and body image components of the child psychosocial assessment scores (r = 0.01 and r = 0.06, respectively) observed by Kelly et al suggests that presence of the deformity, regardless of severity, results in body image and psychosocial difficulties worthy of attention [22]. These authors also found that at one year post surgery, patients reported significant reductions in body image concerns (p < 0.0001) and in difficulties in physical functioning (p < 0.0001), and parents perceived significant improvements in their child's emotional functioning (p < 0.01), confirming psychosocial improvements with treatment, independent of the modality employed [22].…”

“…Nevertheless, the lack of correlation between the anatomic severity of the deformity on CT and the physical and body image components of the child psychosocial assessment scores (r = 0.01 and r = 0.06, respectively) observed by Kelly et al suggests that presence of the deformity, regardless of severity, results in body image and psychosocial difficulties worthy of attention [22]. These authors also found that at one year post surgery, patients reported significant reductions in body image concerns (p < 0.0001) and in difficulties in physical functioning (p < 0.0001), and parents perceived significant improvements in their child's emotional functioning (p < 0.01), confirming psychosocial improvements with treatment, independent of the modality employed [22]. 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].…”

“…Despite the fact that Kelly et al did not explicitly reference poor body image as an indication for repair, body image concerns constitute an important consideration in the pectus deformity patient population. Impairments in psychosocial functioning secondary to poor body image should be explored during the work-up of a pectus deformity patient, as surgical repair of pectus deformity may help to alleviate these concerns [12,[22][23][24]. There is currently no data evaluating the effects of regular psychiatric followup with a psychiatrist on alleviating the psychological burden of poor body image in this patient group.…”

Minimally Invasive Repair of Pectus Excavatum

“…Patients may also increasingly report musculoskeletal complaints, such as back and chest pain, or cardiopulmonary complaints such as dyspnea on exertion and diminished exercise tolerance, which may be related to decreased pulmonary reserve, decreased forced vital capacity, decreased maximal voluntary ventilation, or limitation of cardiac stroke volume (8,9). Furthermore, patients with significant pectus deformities may report palpitations related to mitral valve prolapse, arrhythmias, and atrial & ventricular compression.…”