Cardiorespiratory function before and after operation for pectus excavatum Medium-term results

Abstract Introduction Pectus excavatum (PE) is the most common chest wall deformity. Patients with PE may have cosmetic complaints, restricted physical capabilities, or both and may seek surgical correction. One method to assess satisfaction after surgery is the single step questionnaire (SSQ). Although the developers state that the SSQ produces a stabile score and only needs to be used once, we hypothesized that the score may depend on point in time after surgery. Materials and Methods One hundred and eight patients from a longitudinal cohort of patients undergoing a Nuss bar placement for PE were selected. Mean age was 16.0 years (range: 12–29). SSQ was completed at 6 weeks, 6 months, 1 year, and 2 years postoperatively. Mean and median scores per question and total scores were calculated on each measurement moment. Overall scores were tested using the Friedman test. Results There were significant differences in overall SSQ scores (p < 0.009) throughout the postoperative period, especially between 6 weeks and 6 months (p = 0.006). Scores on general health, exercise capacity, impact on social life, pain during hospital stay, and after discharge changed also significant in the first 2 years after Nuss bar placement. Conclusion There were significant differences in total SSQ score depending on the time of application postoperatively. However, the most clinical relevant difference was between 6 weeks and 6 months. Assessment of the overall satisfaction postoperative with the SSQ questionnaire should not be done with a single measurement but rather at different postoperative time intervals before and after 6 months postoperatively.

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Exercise cardiorespiratory function in adolescents with pectus excavatum

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(19)35630-2 ◽

1990 ◽

Vol 99 (1) ◽

pp. 41-47 ◽

Cited By ~ 61

Author(s):

Susan R. Wynn ◽

David J. Driscoll ◽

Nancy K. Ostrom ◽

Bruce A. Staats ◽

Edward J. O'Connell ◽

...

Keyword(s):

Pectus Excavatum ◽

Cardiorespiratory Function

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Cardiorespiratory Function Before and After Aerobic Exercise Training in Patients With Interstitial Lung Disease

Journal of Cardiopulmonary Rehabilitation and Prevention ◽

10.1097/hcr.0000000000000083 ◽

2015 ◽

Vol 35 (1) ◽

pp. 47-55 ◽

Cited By ~ 17

Author(s):

Randall E. Keyser ◽

Joshua G. Woolstenhulme ◽

Lisa M.K. Chin ◽

Steven D. Nathan ◽

Nargues A. Weir ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Exercise Training ◽

Lung Disease ◽

Aerobic Exercise ◽

Aerobic Exercise Training ◽

Cardiorespiratory Function ◽

Before And After

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EP.TU.310Dancing in the rain: early experience of Enhanced Stress Resilience Training

British Journal of Surgery ◽

10.1093/bjs/znab311.040 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Oliver Luton ◽

Osian James ◽

Katie Mellor ◽

Catherine Eley ◽

Richard Egan ◽

...

Keyword(s):

Qualitative Data ◽

Primary Outcome ◽

Maslach Burnout Inventory ◽

Clinical Work ◽

Medium Term ◽

Before And After ◽

Resilience Training ◽

Stress At Work ◽

Evident Difference ◽

Failure To Progress

Abstract Aim Core Surgical Training (CST) programs are associated with a 60% risk of burnout and failure to progress. This study aimed to assess the influence of a novel Enhanced Stress and Resilience Training (ESRT) course delivered alongside a focused induction at the start of CST in a single UK Statutory Education Body. Method All CST1s were invited to participate in a six-week ESRT course teaching mindfulness-based exercises to develop tools to deal with stress at work and burnout. Primary outcome measures were compliance with ESRT programme and degree of burnout measured using Maslach Burnout Inventory (MBI) scoring. Results Of 43 boot camp attendees, 38 trainees completed questionnaires, with 24 choosing to participate (63.2%; male 13, female 11, median age 28 yr.) Burnout was identified in 23 trainees (60.5%) with no evident difference in baseline MBI scores between participants or not (p = 0.77, median 4 [0-11] vs. 4 [1-11]). MBI scores were comparable before and after ESRT in the intervention cohort (p = 0.63, median 4 [0-11] vs. 4 [1-10]). Qualitative data reflected challenges delivering ESRT because of arduous and inflexible clinical on-call rotas and time pressures related to academic curriculum demands. Despite these challenges, 22 (91.6%) considered the course valuable, 14 (58.3%) continued to use the techniques in daily clinical work there was and unanimous support to continue the program in future. Conclusion ESRT was feasible and further research is warranted to determine its medium-term efficacy.

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Two-dimensional and three-dimensional echocardiographic assessment of right ventricular function in patients with pectus excavatum, before and after surgery

Chinese Medical Journal ◽

10.1097/cm9.0000000000001414 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Xin Zhang ◽

Cheng-Hao Chen ◽

Ning Ma ◽

Lin Zheng ◽

Pei Li ◽

...

Keyword(s):

Right Ventricular ◽

Ventricular Function ◽

Right Ventricular Function ◽

Pectus Excavatum ◽

Three Dimensional ◽

Two Dimensional ◽

Before And After ◽

Echocardiographic Assessment

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Abstract 13730: Electrical Axes of P and T but Not QRS Waves on ECG Are New Indicators of Successfulness of the Nuss Operation for Pectus Excavatum Considering Anatomical Severity as Indicated by the Haller Index Acquired by CT

Circulation ◽

10.1161/circ.142.suppl_3.13730 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Nobusada FUNABASHI ◽

Yoshio Kobayashi

Keyword(s):

Pectus Excavatum ◽

Correlation Coefficients ◽

P Wave ◽

Invasive Technique ◽

P Waves ◽

Haller Index ◽

Before And After ◽

Group 2 ◽

Group 1 ◽

T Waves

Introduction: Pectus excavatum (PEX) is a depression of the sternum which can physically constrict the heart and cause abnormal ECGs. The Nuss operation is a minimally invasive technique for PEX repair. Hypothesis: As right (RA) and left atria (LA) are compressed in PEX, axes of P, QRS, and T waves are abnormal and the Nuss operation normalizes them. We also took the Haller index (HI) into to account. Methods: 17 PEX patients (14 male, 12±6 years) underwent CT and ECG before and after the Nuss operation. Results: All Nuss operations were successful, and HI was significantly improved from 5.62±2.29 to 3.29±0.65 (P=0.0002). There were no significant differences before and after surgery for electrical axes of P waves (46±20 vs 65±55, P=0.20), and QRS waves (75±33 vs 76±23, P=0.72), but T waves were greater thereafter (22±27 vs 40±19, P=0.001). Correlation coefficients (CC) between the degree of axes of P, QRS and T waves, and HI before operation were -0.23, -0.06, and 0.11, respectively. These values after operation were -0.25, -0.06, and 0.19, respectively. As HI is an indirect indicator of heart compression, we evaluated the degree of RA and LA compression qualitatively as none, mild, and moderate/more. Of 17 patients, 5 had moderate/more compression of RA and/or LA by PEX (group 1); the remaining 12 did not show compression (group 2). Only P wave values were significantly smaller in group 1 than 2 before surgery, but these differences disappeared after surgery. In both groups, degree of axes of T waves was significantly greater after the operation. Conclusion: In patients with PEX, axes of T waves after the Nuss operation became significant greater than before the operation in patients with moderate or more compression of RA and/or LA by PEX. For P waves, this was smaller before the operation in those with compression but this was improved by the Nuss operation. P and T wave axes but not QRS could be therefore non-invasive indicators of Nuss operation success in addition to gross PEX appearance.

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