Article

Quality-of-life outcomes after surgical correction of pectus excavatum: a comparison of the Ravitch and Nuss procedures.

Division of Pediatric General Surgery, Department of Surgery, BC Children's Hospital, University of BC, Vancouver, BC, Canada V6H 3V4.
Journal of Pediatric Surgery (impact factor: 1.45). 06/2008; 43(5):819-25. DOI:10.1016/j.jpedsurg.2007.12.020 pp.819-25
Source: PubMed

ABSTRACT The purpose of this study was to compare clinical and health-related quality-of-life (HRQL) outcomes within a group of patients treated for pectus excavatum (PE).
A retrospective 3-year review of patients undergoing Nuss or Ravitch correction of PE was performed. Health-related quality-of-life assessment was performed using the Child Health Questionnaire (CHQ-CF87) and the 17-item Pectus Excavatum Evaluation Questionnaire, and results were compared between groups and with age-matched CHQ-CF87 normative data.
Forty-three patients (39 males; 91%) underwent surgery; 19 (44%) by Nuss procedure. Duration of postoperative opioid analgesia and length of hospital stay (LOS) were significantly longer in Nuss patients. The overall survey response rate was 53%. The groups differed significantly in the CHQ on one item (Change in Health). On the Pectus Excavatum Evaluation Questionnaire, Nuss patients reported being "less bothered" by the appearance of their chest. Compared to Australian age-matched norms, the aggregate PE sample showed better scores for family activity domain and worse scores in mental health, general health perceptions, change in health, bodily pain, and self-esteem.
Patients undergoing surgery for PE by either Nuss or Ravitch procedure have similar clinical and HRQL outcomes, but as a group have poorer HRQL scores than age-matched population norms.

0 0
 · 
0 Bookmarks
 · 
29 Views
  • Article: Pectus excavatum: history, hypotheses and treatment options.
    Christoph Brochhausen, Salmai Turial, Felix K P Müller, Volker H Schmitt, Wiltrud Coerdt, Jean-Marie Wihlm, Felix Schier, C James Kirkpatrick
    [show abstract] [hide abstract]
    ABSTRACT: Pectus excavatum and pectus carinatum represent the most frequent chest wall deformations. However, the pathogenesis is still poorly understood and research results remain inconsistent. To focus on the recent state of knowledge, we summarize and critically discuss the pathological concepts based on the history of these entities, beginning with the first description in the sixteenth century. Based on the early clinical descriptions, we review and discuss the different pathogenetic hypotheses. To open new perspectives for the potential pathomechanisms, the embryonic and foetal development of the ribs and the sternum is highlighted following the understanding that the origin of these deformities is given by the disruption in the maturation of the parasternal region. In the second, different therapeutical techniques are highlighted and based on the pathogenetic hypotheses and the embryological knowledge potential new biomaterial-based perspectives with interesting insights for tissue engineering-based treatment options are presented.
    Interactive cardiovascular and thoracic surgery 03/2012; 14(6):801-6.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

17-item Pectus Excavatum Evaluation Questionnaire
 
age-matched CHQ-CF87 normative data
 
age-matched population norms
 
aggregate PE sample
 
Child Health Questionnaire
 
family activity domain
 
general health perceptions
 
health-related quality-of-life
 
Health-related quality-of-life assessment
 
mental health
 
Nuss patients
 
patients undergoing Nuss
 
Patients undergoing surgery
 
pectus excavatum
 
Pectus Excavatum Evaluation Questionnaire
 
postoperative opioid analgesia
 
Ravitch correction
 
retrospective 3-year review
 
survey response rate
 
worse scores