Quality of Life and Pain Syndrome in Patients With Thoracic Aorta Repair Using a Mini-Sternotomy

Abstract

Aim      To determine the effect of minimally invasive interventions on the quality of life (QoL), pain syndrome, and cosmetic effect in patients with a pathology of chest aorta as compared with a group of traditional access.Material and methods  From 2016 through 2020, 77 of 226 (34%) patients with an aneurysm in the proximal chest aorta and mini-sternotomy were prospectively selected starting from 2017. To evaluate differences between the effects of mini-sternotomy and the traditional access on QoL and pain syndrome a control group of patients with full sternotomy (n=77) was formed using pseudorandomization. Intergroup comparison of QoL, pain syndrome, and cosmetic parameters was performed at various time points.Results Mini-sternotomy provided a decrease in pain syndrome both during the early period (day 3), and during movements upon discharge. Also, mini-sternotomy decreased the duration of stay in the hospital compared to full sternotomy (8.1±2.1 vs. 8.9±2.5 days, respectively; р>0.0331). A more frequent use of analgesics by patients with full sternotomy was noted. Mini-sternotomy was associated with a faster recovery of most QoL parameters according to the SF-36 questionnaire at one year after surgery. The questionnaire included summarizing parameters of physical and mental health components (Physical Health Component, Physical Health (PH): 54.3±11.9 vs. 58.2±8.2, respectively; p=0.046; Mental Health Component, Mental Health (MH): 53.8±6.8 vs. 57.8±9.5, respectively; p=0.013). In addition, patients with minimal access showed higher values of the cosmetic effect by a 5-score scale (4.08±0.8 vs. 4.39±0.8, respectively; p=0.049) and a greater interest to having a minimal access surgery.Conclusion      Mini-sternotomy beneficially influences the pain syndrome, cosmetic outcome, and QoL and provides a shorter duration of rehabilitation and a sooner return to work and everyday life compared to full sternotomy.