Aspects of indication setting for selection of individual therapy and informed consent

Abstract

The type of the surgical correction, which finally will be applied in the correction of a funnel chest deformity occasionally depends there from, to which specialty physician the patient is referred. While thoracic and pediatric surgeons rather will propose the repositioning intervention of the thoracic wall, plastic surgeons might preferably apply different techniques of tissue replacement. Such a pre-selection is depending on the facts, which surgical spectrum and know-how is available at the respective institution. However, just such a course of selection does not represent an optimal selection of treatment that meets the requirements of the patient bearing the aesthetic or functional burden of deformity. Preferably an interdisciplinary discussion of all cases would be of advantage for the concerned patients, but rather not a selection of a procedure, which is just manageable in a singular institution [9]. Being based on the interdisciplinary pool at knowledge and experiences that usually and of course is more comprehensive (“comprehensive care”) than a singular expert’s opinion, the appropriate choice of treatment or, in selected cases even refusal of any surgical therapy has to be made.

The degree of abnormality that is determinable by clinical and laboratory examination is not necessarily proportional to the symptoms the patient has. R. Ravitch