The Quality of Life After Bar Removal in Patients After the Nuss Procedure for Pectus Excavatum

Kim, Hyun Koo; Shim, Jae Hoon; Choi, Kyu Sun; Choi, Young Ho

doi:10.1007/s00268-011-1111-x

Cited by 21 publications

(26 citation statements)

References 31 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: 95%

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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: 95%

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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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“…Furthermore, the impact of pain management on patient satisfaction was not yet systematically evaluated 1,16 . In a retrospective cohort developed in the United States, there was an increase of 12% in direct costs in the Nuss group, but the total hospitalization costs were lower, with a saving of 27% in patients undergoing the minimally invasive technique 16,24 . Complete economic evaluations on this technology, however, are not available 1,12 .…”

Section: Results Results Results Resultsmentioning

confidence: 99%

“…However, this parameter is superficially evaluated by the available literature 12,24 . The validation of instruments to evaluate this outcome is necessary to increase the understanding of the processes involving the psychosocial aspects of the deformity, especially in patients of different age groups and cultural characteristics 24 .…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Nuss procedure for Pectus excavatum repair: critical appraisal of the evidence

Araújo

Penha

Westphal

et al. 2014

Rev. Col. Bras. Cir.

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Objective: To evaluate the effectiveness and safety of correction of pectus excavatum by the Nuss technique based on the available scientific evidence.Methods: We conducted an evidence synthesis following systematic processes of search, selection, extraction and critical appraisal. Outcomes were classified by importance and had their quality assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).Results: The process of selection of items led to the inclusion of only one systematic review, which synthesized the results of nine observational studies comparing the Nuss and Ravitch procedures. The evidence found was rated as poor and very poor quality. The Nuss procedure has increased the incidence of hemothorax (RR = 5.15; 95% CI: 1.07; 24.89), pneumothorax (RR = 5.26; 95% CI: 1.55; 17.92) and the need for reintervention (RR = 4.88; 95% CI: 2.41; 9.88) when compared to the Ravitch. There was no statistical difference between the two procedures in outcomes: general complications, blood transfusion, hospital stay and time to ambulation. The Nuss operation was faster than the Ravitch (mean difference [MD] = -69.94 minutes, 95% CI: -139.04, -0.83).Conclusion: In the absence of well-designed prospective studies to clarify the evidence, especially in terms of aesthetics and quality of life, surgical indication should be individualized and the choice of the technique based on patient preference and experience of the team.

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Pectus Excavatum Remodelling by CAD Custom-Made Silicone Implant: Experience of 600 Cases

Chavoin

Dahan

Moreno³

et al. 2019

Pectus Excavatum and Poland Syndrome Surgery

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The Quality of Life After Bar Removal in Patients After the Nuss Procedure for Pectus Excavatum

Abstract: The Nuss procedure had a positive impact on the patients' and parents' quality of life. However, the scores before and after bar removal did not differ.

Cited by 21 publications

References 31 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

Nuss procedure for Pectus excavatum repair: critical appraisal of the evidence

Pectus Excavatum Remodelling by CAD Custom-Made Silicone Implant: Experience of 600 Cases

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