Department of Thoracic Surgery, Marmara University, Faculty of Medicine, Istanbul, Turkey.
Eur J Cardiothorac Surg. 2013 Jan;43(1):122-6. doi: 10.1093/ejcts/ezs146. Epub 2012 Apr 6.
Several studies previously demonstrated an improvement in the quality of life (QoL) of the patients undergoing a minimally invasive repair of pectus excavatum, but there are no data about such improvement following the minimally invasive repair of pectus carinatum (PC) deformity. The purpose of this study was to investigate the effects of the minimally invasive repair of PC deformity on the psychosocial and physical functioning of the patients.
Among 40 patients who underwent minimally invasive repair for PC deformity from July 2008 to March 2011, 35 patients accepted to answer the QoL questionnaires, and 30 of them who had completed the postoperative 6th month were evaluated in this study. The modified two-step Nuss questionnaire was used for the QoL assessment. All patients and their parents completed the appropriate questionnaires regarding the patients' preoperative psychosocial and physical functioning, and they were asked to answer the same questions on the postoperative 6th month. The results from these questionnaires were analysed using Wilcoxon signed rank test to investigate the effects of the minimally invasive repair of PC deformity on psychosocial and physical functioning of the patients.
The questionnaires used in the study confirmed the positive impact of the surgical correction on psychosocial and physical well-being in the patients and their parents. Spearman's ρ correlation coefficient determined how well the answers to the same question at two different times correlated with each other, and Cronbach's alpha demonstrated the internal consistency of these answers. These two parameters showed that the statistical results of the study were reliable enough. Statistical analysis of the scoring of the individual questions and the total scoring of individual patients revealed a statistically significant improvement (P < 0.05) following surgery. Similar significant improvements were observed in the total scoring of individual parents and in most scoring of the individual questions (10 of 13, 77%) in the parental questionnaire (P < 0.05).
The results of this study confirm for the first time that minimally invasive repair of PC deformity has a positive impact on both psychosocial and physical functioning of the patient, which is supported by parental assessment.
多项研究此前已证实微创漏斗胸修复术可提高患者生活质量（QoL），但微创鸡胸修复术（PC）后患者 QoL 是否改善尚无相关数据。本研究旨在探讨微创 PC 修复术对患者心理社会和身体功能的影响。
2008 年 7 月至 2011 年 3 月，40 例 PC 畸形患者接受微创修复术，其中 35 例患者接受 QoL 问卷评估，30 例患者完成术后 6 个月评估。采用改良两步 Nuss 问卷进行 QoL 评估。所有患者及其父母均完成了患者术前心理社会和身体功能的适当问卷，并要求他们在术后 6 个月回答相同的问题。采用 Wilcoxon 符号秩检验分析这些问卷的结果，以探讨微创 PC 修复术对患者心理社会和身体功能的影响。
研究中使用的问卷证实了手术矫正对患者及其父母心理社会和身体健康的积极影响。Spearman ρ 相关系数确定了同一问题两次回答之间的相关性，Cronbach's α 则显示了这些回答的内部一致性。这两个参数表明，研究的统计结果具有足够的可靠性。对个别问题的评分和个别患者的总分进行统计分析显示，术后评分显著提高（P < 0.05）。个体父母问卷的总分和大部分个体问题的评分（13 个问题中的 10 个，77%）也观察到了类似的显著改善（P < 0.05）。
本研究首次证实微创 PC 修复术对患者的心理社会和身体功能均有积极影响，且这种影响得到了父母评估的支持。
