Improvement in Quality of Life of Pectus Excavatum Patients after Nuss Procedure

Abstract

Background: Pectus Excavatum (PE) is the most common anterior chest wall deformity. It is prevalent approximately 1:300 to 400 live births. In general, the patients with this deformity are doing well although the depression of the sternum is believed to compress the right ventricular outflow tract or to reduce lung volume. Majority of teenager and young adult patients, however, are concerned about their body image and even poor self-esteem. Nowadays, minimally invasive repair of pectus excavatum (MIRPE), so called Nuss procedure, is accepted as a standard treatment that offers less postoperative pain, safety and satisfactory outcome. Additionally, the procedure improves quality of life of the patients in terms of either physical or psychological aspect, determined by a specifically validated questionnaire. Objective: To evaluate the improvement of quality of life in PE patients after MIRPE. Materials and Methods: We collected data of 150 PE patients from January 2006 to December 2018. Informed consent was obtained from all patients before responding the Nuss questionnaire modified for adult pre- and postoperatively. A single-step-questionnaire was applied for postoperative evaluation of quality of life. Statistical analysis, paired t-test was used to compare patients' preoperative and postoperative quality of life. Results: Among 150 patients, the average score of questionnaires was significantly increased from 2.99 (SD=0.52) preoperatively to 3.68 (SD=0.33) postoperatively (p-value <0.05). Self-esteem was improved from 7.03 (SD=1.75) to 8.74 (SD=0.91). Overall satisfaction score was 4.11 (SD=0.37). Conclusion: Nuss procedure has improved the quality of life of the patients with pectus excavatum after surgery. However, further periodic follow-up must be exercised to determine long-term outcome as well as satisfaction after the removal of the Nuss bar.