This study aimed to review the literature with regard to the psychological aspects in patients with pectus excavatum (PE) and pectus carinatum (PC).
Methods
The literature was reviewed by analyzing articles on PubMed using the search terms “psychology” and “pectus.”
Results
The literature search revealed 22 articles that offered a total of 2214 patients for analysis. Regarding chest wall deformities (CWD), there were 15 articles referring to PE, 4 articles on PC, and 3 pertaining to both PE and PC. Authors used various types of questionnaires and 14 studies which also included a parent questionnaire. There are 14 reports which analyzed both the preoperative and postoperative psychological status and 4 reports in which a control group was used. Treatment of CWD was shown to have consistently positive results. There is no consensus regarding the correlation between severity of CWD and psychological issues. Only 2 studies found no statistically significant results after treatment.
Conclusions
The literature reveals a great concern for psychosocial issues in CWD patients. Most articles describe improvement in overall quality of life (QOL) after surgery. An increase in social and physical function, body image, and self-esteem was observed in CWD patients, which is supported by parent responses.
RumseyNHarcourtD. Body image and disfigurement: issues and interventions. Body Image. 2004;1:83-97.
3.
JiYLiuWChenSXuBTangYWangX, et al.Assessment of psychosocial functioning and its risk factors in children with pectus excavatum. Health Qual Life Outcome. 2011;9:28. doi:10.1186/1477-7525-9-28Published 2011 May 4
4.
BostanciKOzalperMHEldemB, et al.Quality of life of patients who have undergone the minimally invasive repair of pectus carinatum. Eur J Cardio Thorac Surg. 2013;43(1):122-126. doi:10.1093/ejcts/ezs146
5.
JacobsenEBThastumMJeppesenJHPilegaardHK. Health-related quality of life in children and adolescents undergoing surgery for pectus excavatum. Eur J Pediatr Surg. 2010;20(2):85-91. doi:10.1055/s-0029-1243621
6.
SteinmannCKrilleSMuellerAWeberPReingruberBMartinA. Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. Eur J Cardio Thorac Surg. 2011;40(5):1138-1145. doi:10.1016/j.ejcts.2011.02.019
7.
HadoltBWallischAEggerJWHöllwarthME. Body-image, self-concept and mental exposure in patients with pectus excavatum. Pediatr Surg Int. 2011;27(6):665-670. doi:10.1007/s00383-011-2854-z
8.
KrilleSMüllerASteinmannCReingruberBWeberPMartinA. Self- and social perception of physical appearance in chest wall deformity. Body Image. 2012;9(2):246-252. doi:10.1016/j.bodyim.2012.01.005
9.
ColozzaSBütterA. Bracing in pediatric patients with pectus carinatum is effective and improves quality of life. J Pediatr Surg. 2013;48(5):1055-1059. doi:10.1016/j.jpedsurg.2013.02.028
10.
KuruPBostanciKErmerakNOBahadirATAfacanCYukselM. Quality of life improves after minimally invasive repair of pectus excavatum. Asian Cardiovasc Thorac Ann. 2015;23(3):302-307. doi:10.1177/0218492314553442
11.
KnudsenMVGrosenKPilegaardHKLaustsenS. Surgical correction of pectus carinatum improves perceived body image, mental health and self-esteem. J Pediatr Surg. 2015;50(9):1472-1476. doi:10.1016/j.jpedsurg.2014.11.048
12.
LomholtJJJacobsenEBThastumMPilegaardH. A prospective study on quality of life in youths after pectus excavatum correction. Ann Cardiothorac Surg. 2016;5(5):456-465. doi:10.21037/acs.2016.08.02
13.
LuoLXuBWangXTanBZhaoJ. Intervention of the nuss procedure on the mental health of pectus excavatum patients. Ann Thorac Cardiovasc Surg. 2017;23(4):175-180. doi:10.5761/atcs.oa.17-00014
14.
Horn-HofmannCScheelJDimovaV, et al.Prediction of persistent post-operative pain: Pain-specific psychological variables compared with acute post-operative pain and general psychological variables. Eur J Pain. 2018;22(1):191-202. doi:10.1002/ejp.1115
15.
BahadirATKuru BektaşoğluPÇakiroğlu EserAAfacanCYükselM. Psychosocial functioning in pediatric patients with pectus excavatum and pectus carinatum. Turk J Med Sci. 2017;47(3):771-777. doi:10.3906/sag-1511-66Published 2017 June 12
16.
KellyREJrDanielA. Outcomes, quality of life, and long-term results after pectus repair from around the globe. Semin Pediatr Surg. 2018;27(3):170-174. doi:10.1053/j.sempedsurg.2018.05.003
17.
ZuidemaWPOosterhuisJWAZijpGWvan der HeideSMvan der SteegAFWvan HeurnLWE. Early consequences of pectus excavatum surgery on self-esteem and general quality of life. World J Surg. 2018;42(8):2502-2506. doi:10.1007/s00268-018-4526-9
18.
PaulsonJFEllisKObermeyerRJ, et al.Development and validation of the pectus carinatum body image quality of life (PeCBI-QOL) questionnaire. J Pediatr Surg. 2019;54(11):2257-2260. doi:10.1016/j.jpedsurg.2019.03.019
19.
ZuidemaWPvan der SteegAFWvan der HeideS, et al.The outcome of the single step questionnaire in pectus excavatum patients is phase dependent. Eur J Pediatr Surg. 2020;30(2):205-209. doi:10.1055/s-0039-1681025
20.
KeithKSchalockRAssessing the quality of student life. Issues Spec Educ Rehabil1992;7:87-97.
21.
KellyREJrCashTFShambergerRC, et al.Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: Multicenter study. Pediatrics. 2008;122(6):1218-1222. doi:10.1542/peds.2007-2723
22.
KrasopoulosGDusmetMLadasGGoldstrawP. Nuss procedure improves the quality of life in young male adults with pectus excavatum deformity. Eur J Cardio Thorac Surg. 2006;29(1):1-5. doi:10.1016/j.ejcts.2005.09.018
23.
MoherD.LiberatiA.TetzlaffJ.AltmanDG.. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6:e1000097.
24.
RobertsJHayashiAAndersonJOMartinJMMaxwellLL. Quality of life of patients who have undergone the Nuss procedure for pectus excavatum: Preliminary findings. J Pediatr Surg. 2003;38(5):779-783. doi:10.1016/jpsu.2003.50166
25.
MetzelderMLKueblerJFLeonhardtJUreBMPetersenC. Self and parental assessment after minimally invasive repair of pectus excavatum: lasting satisfaction after bar removal. Ann Thorac Surg. 2007;83(5):1844-1849. doi:10.1016/j.athoracsur.2006.12.064
26.
SigaletDLMontgomeryMHarderJWongVKravarusicDAlassiriA. Long term cardiopulmonary effects of closed repair of pectus excavatum. Pediatr Surg Int. 2007;23(5):493-497. doi:10.1007/s00383-006-1861-y
