# Long term evaluation of patient satisfaction and quality of life in patients undergone successfuL Nuss procedure

## TL;DR

This study evaluates long-term patient satisfaction and quality of life after the Nuss procedure for pectus excavatum, finding that younger patients and those without pain report better outcomes.

## Contribution

The study provides novel long-term insights into age-dependent outcomes and factors influencing satisfaction after the Nuss procedure.

## Key findings

- Pediatric patients showed higher satisfaction scores in physical functioning and pain domains compared to adolescents and adults.
- Advanced age at surgery and preoperative chest pain were significant negative predictors of satisfaction.
- Patients with cosmetic indications reported greater self-esteem and total satisfaction improvements.

## Abstract

Pectus excavatum represents the most common chest wall deformity, and surgical correction via the Nuss procedure has gained widespread adoption. Long-term patient satisfaction and quality of life remain inadequately characterized, particularly with respect to age-dependent outcomes and factors influencing satisfaction. To evaluate long-term patient satisfaction and quality of life in pediatric, adolescent, and adult patients who underwent successful Nuss procedures and to identify factors predictive of sustained improvement.

We conducted a retrospective analysis of 40 patients who underwent the Nuss procedure between 2010 and 2020. Patient satisfaction and quality of life were assessed via the single-step questionnaire (SSQ). Patients were stratified by age groups: children (≤ 12 years), adolescents (13–17 years), and adults (≥ 18 years). Statistical analyses included comparisons between age groups and genders, correlation analyses, and multiple regression to identify predictors of satisfaction.

Patients demonstrated favorable long-term outcomes. Pediatric patients presented significantly higher scores in the physical functioning, pain/discomfort, and total SSQ domains than adolescents and adults did. Age at operation was negatively correlated with satisfaction outcomes. Preoperative chest pain was associated with lower satisfaction. Patients with primarily cosmetic indications reported greater self-esteem improvement and total satisfaction. Multiple regression analysis revealed that advanced age at operation, preoperative chest pain, and postoperative chronic pain were significant negative predictors of satisfaction.

The Nuss procedure provides durable patient satisfaction across multiple quality-of-life domains, with age-dependent variations. Earlier intervention, when clinically appropriate, may optimize long-term outcomes. Effective management of both pre- and postoperative pain is crucial for maximizing patient satisfaction.