Psychological trauma of funnel chest in adolescents and the appropriate age for minimally invasive surgery repair.
BACKGROUND
Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents' psychological and behavior. This study aimed to investigate the psychological characteristics and factors that affect adolescents with funnel chest and to evaluate the relationship between the patients' age and their physiological and psychological health. We aimed to establish an age model for maximum surgery benefits for funnel chest patients to provide an objective basis for choosing surgery.


METHODS
The study adopted a general evaluation approach to assess the risk and benefits of minimally invasive surgery for funnel chest. The funnel chest index, the Symptom Checklist-90, and the Eysenck Personality Questionnaire were used as assessment tools to observe physiological and psychological features in funnel chest patients. A sample of 234 adolescents with funnel chest was selected from a third-grade class-A hospital in Beijing. Age groups were adopted as an independent variable, and other factors in funnel chest patients were dependent variables.


RESULTS
There was a significant difference in the relapse rate for funnel chest in the different age groups (χ(2) = 11.883, P = 0.008). There was a higher relapse rate in patients of ≤10 or ≥19 years old than in patients of 11-18 years old. There was a significant difference in the SCL-90 total score in the different age groups (F = 12.538, P = 0.0001), the patients older than 13 years had a higher score than those younger than 13 years in the SCL-90. There was a significant difference in the standard score of E (introversion/ extraversion) in the different age groups (F = 10.06, P = 0.0001). There was also a significance in the funnel chest index before surgery in the different psychological scales (P < 0.01), with a higher funnel chest index score associated with more obvious psychological trauma. Age and the number of variables, including the relapse rate, SCL-90 score, standard score of E, and standard score of N in the EPQ were significantly correlated (correlation indices were 0.402, 0.623, -0.505, and 0.473, respectively, P < 0.01).


CONCLUSIONS
There are higher complication rates after surgery and relapse rates when funnel chest patients are too young or too old. There is more obvious psychological trauma in patients with a high funnel chest index. Our results indicate that the best age for surgery for funnel chest is 14-16 years.
Department of Thoracic Surgery, Military General Hospital of Beijing People's Liberation Army, Beijing 100700, China.
Jing
J
Zhao
Li
L
Luo
Li-jun
LJ
Xiao
Ling-yun
LY
Gu
Tian-sheng
TS
Sun
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005660:Funnel Chest / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D011581:Psychological Tests; D000297:Psychology, Adolescent