Quality of life assessment after minimally invasive operative treatment in children with pectus excavatum: A single-center study and literature review.

Abstract

Background: Most patients with chest wall deformities have a negative body image, which affects their self-esteem and quality of life (QoL).

Objectives: The aim of this study was to evaluate changes in patients' QoL after minimally invasive repair of pectus excavatum (MIRPE).

Material and methods: A prospective, single-center study was conducted between 2019 and 2023. We included 20 pediatric patients at a median age of 15 years and 9 months who underwent MIRPE. Two QoL questionnaires were used: the KIDSCREEN-52 and the EQ-5D-Y. The data were statistically analyzed with the Wilcoxon and Mann-Whitney tests. All patients and their parents were asked to complete questionnaires preoperatively and 12 months after surgical treatment.

Results: All patients were followed up during the 12-month study period. The study group was comprised of 65% male patients. The median Haller index was 5.0 standard deviation (SD) = 1.58). The assessment of general health condition was higher among the boys (with postoperative improvement), though this finding was not statistically significant. Routine daily activities were easier for all patients after MIRPE (p = 0.048). The patients showed improved physical activity (p = 0.038) and psychological wellbeing (p = 0.013) after elevation of the anterior chest wall. There was no impact on relations with parents, free time or school environment, but we found better patient contact with peers in the postoperative period. A high correlation was confirmed between the parents' and the patients' responses in each questionnaire.

Conclusions: Chest wall deformities can have a strong impact on the patient's wellbeing, which is a very important part of psychological development in adolescents. Our study showed that improved QoL should be always considered as an indication for surgical treatment of chest wall deformities in children.