Göğüs Duvarı Deformitelerinde Uygulanan Non-Operatif Tedavide Hasta Memnuniyeti

Abstract

Patients who underwent non-operative treatment for chest wall deformities at Hacettepe University Faculty of Medicine Department of Pediatric Surgery between 2018-2023 were retrospectively reviewed. 20 PE patients (15 male, 5 female; median age 9.0 years) and 10 PC patients (8 male, 2 female; median age 14.25 years) were included in the study. The time from noticing the deformity to diagnosis was median 15.0 months (25-75 percentile: 8.0-19.0) in the PE group and median 12.0 months (25-75 percentile: 10.0-14.0) in the PC group. Demographic data, anthropometric measurements, cardiopulmonary evaluations, and Body Image-Quality of Life questionnaire results were assessed. Vacuum therapy was applied to PE patients and compression brace therapy to PC patients. In the PE group, after median 10.0 months of treatment, a median 68.3% improvement in deformity depth at 12-month follow-up (25-75 percentile: 60.4%-75.4%), median 1.2 cm (25-75 percentile: 0.75-1.4) improvement in anteroposterior diameter, treatment motivation score of median 49.0, and Haller index of median 2.94 (25-75 percentile: 2.40-3.50) were achieved. In the PC group, after median 12.0 months of treatment, a 66.7% reduction in correction pressure (25-75 percentile: 62.2%-66.7%), median 1.5 cm (25-75 percentile: 1.3-2.5) improvement in anteroposterior diameter, and treatment motivation score of median 50.5 were obtained. In patient questionnaires, physical limitations score was significantly higher in the PE group (median 15.0 vs 7.0, p=0.001), while no significant difference was found between groups in terms of body image disturbance, treatment motivation and social disadvantage. In parental evaluations, body image disturbance and physical limitations were higher in the PE group, while treatment motivation was higher in the PC group. In conclusion, non-operative treatment methods provide objective anatomic improvement and positive psychosocial outcomes with appropriate patient selection and treatment compliance. It has been demonstrated that quality of life, body image, and psychosocial parameters should be evaluated in addition to anatomic improvement in assessing treatment success.