Avaliação pós-operatória da qualidade de vida em pacientes submetidos a correção de pectus excavatum

Abstract

BACKGROUND: Pectus excavatum (PE) is a congenital deformity characterized by the depression of the anterior chest wall with deviation of the sternum, cartilages and ribs. Patients can show many different physical symptoms caused by the possible heart and chest compression, but the esthetic complaints seem to be the most frequent ones and may be associated with psychosocial changes and quality of life (QL) changes. Minimally invasive surgical correction (Nuss procedure) was introduced only 20 years ago and quickly gained popularity for the good esthetical results obtained by the technic. OBJECTIVES: To evaluate the level of satisfaction and QL of patients with PE during postoperative phase of Nuss procedure; determinate the level of satisfaction of patients and their parents after surgical correction. METHODS: This is a cross-sectional study. Patients subjected to surgical treatment of PE with the Nuss procedure in public and private hospitals of Manaus were selected and interviewed between December 2016 and July 2017. All patients answered, in a retrospective form, a specific questionnaire for evaluation of QL in patients with PE, the Pectus Excavatum Evaluation Questionnaire (PEEQ), at two moments: before and after the surgery. For patients under 18 years old, it was requested that both the patient and the parents answered the generic questionnaire CHQ, and those 18 years old and over answered the generic questionnaire of QL SF 36. The average and the standard deviation of the obtained answers were calculated and compared to the results from before and after the surgery through the Student’s t-test. RESULTS: 23 patients and 11 parents were interviewed. 82% of the patients were male and their interview happened after an average of three years after the surgery. From the patients’ perspective, there was improvement in all psychosocial aspects after the surgery. As to physical aspects, there was improvement in the occurrence of shortness of breath and fatigue after the surgery. From the parents perspective, the changes in psychosocial aspects were lower. Parents related worrying less about the effects of PE on their children’s life after the surgery. Considering physical aspects, parents reported partial improvement and did not observe improvement in the difficulty of exercising and in the frequency of chest pain after surgical correction. CONCLUSIONS: Surgical correction of PE through Nuss procedure provided significant improvement of patients’ QL, especially on psychosocial aspects either from the patient’s perspective as well as parents.