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Nonoperative management of pectus excavatum with vacuum bell therapy: A single center study

      Abstract

      Purpose

      The purpose of this study was to determine variables predictive of an excellent correction using vacuum bell therapy for nonoperative treatment of pectus excavatum.

      Methods

      A single institution, retrospective evaluation (IRB 15-01-WC-0024) of variables associated with an excellent outcome in pectus excavatum patients treated with vacuum bell therapy was performed. An excellent correction was defined as a chest wall depth equal to the mean depth of a reference group of 30 male children without pectus excavatum.

      Results

      Over 4 years (11/2012–11/2016) there were 180 patients enrolled with 115 available for analysis in the treatment group. The reference group had a mean chest wall depth of 0.51 cm. An excellent correction (depth ≤ 0.51 cm) was achieved in 23 (20%) patients. Patient characteristics predictive of an excellent outcome included initial age ≤ 11 years (OR = 3.3,p = .013), initial chest wall depth ≤ 1.5 cm (OR = 4.6,p = .003), and chest wall flexibility (OR = 14.8,p < .001). Patients that used the vacuum bell over 12 consecutive months were more likely to achieve an excellent correction (OR = 3.1,p = .030). Follow-up was 4 months to 4 years (median 12 months).

      Conclusion

      Nonoperative management of pectus excavatum with vacuum bell therapy results in an excellent correction in a small percentage of patients. Variables predictive of an excellent outcome include age ≤ 11 years, chest wall depth ≤ 1.5 cm, chest wall flexibility, and vacuum bell use over 12 consecutive months.

      Type of study

      Retrospective chart review.

      Level of evidence

      Level III treatment study.

      Key words

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