Project Title

Physiologic and Psychological Effects of Pectus Excavatum Correction

Background

PE is the most common chest wall deformity, affecting approx.1 in 400-500 individuals. Patients often experience reduced exercise tolerance and poor self-image compared to healthy individuals. The minimally invasive repair of PE (MIRPE) is the gold-standard surgical treatment, and is typically performed on children and adolescents with considerable perioperative complication rates. The benefits and risks of MIRPE have yet to be evaluated by a randomized controlled trial.

Aim

The aims of this PhD are to determine if MIRPE improves CRF (measured by V̇ O2max) and psychological outcomes in patients with PE, through high-quality randomized studies.

Methods

Study 1: RCT (n~110 patients) comparing immediate (intervention group) versus delayed MIRPE (control group), measuring V̇ O2max and patient reported questionnaires assessing psychological aspects. The outcomes will be assessed at two time points: preoperatively and 12 months postoperatively.

Study 2: RCT (n~18 patients) assessing immediate effects of the vacuum bell device on cardiac function evaluated with cardiac MRI.

Study 3: RCT (n~10 patients) examining perioperative cardiac output and dimension changes during MIRPE measured with a Swan-Ganz catheter under dobutamine stress.

Perspectives

These studies will address the lack of high-quality evidence on the physiological and psychological benefits of PE surgery, which is crucial given the high surgical complication rates and the ongoing debate in the medical community.