Determinants of success associated with vacuum bell treatment of pectus excavatum
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Read the article on jpedsurg.org ↗Article · Apr 2022 · 1 min read
In brief
In brief
Retrospective study of 186 pectus excavatum patients treated with vacuum bell therapy found 17% achieved complete correction with 34% dropout rate. Success predictors included initial chest depth ≤1.8 cm and treatment duration ≥12 months, with one-third achieving excellent/good outcomes per Obermeyer classification.
Written by the GCMD Library team from the article.
Background/Purpose
We explored determinants of success in a large cohort of patients with pectus excavatum submitted to vacuum bell treatment and compared groups with satisfactory versus unsatisfactory outcomes.
Methods
Retrospective case-control study in a single center between May 2013 and January 2020, including patients with pectus excavatum treated with vacuum bell. We classified patients according to their status at closure of data registry (surveillance; withdrawal; complete correction; failure) and according to Obermeyer's classification of degrees of pectus excavatum correction. Determinants of success were calculated using receiver operating characteristic curves.
Results
Overall, 186 patients were included. Complete correction was achieved by 17% of the cases, while 45% remained under surveillance. Failure rates were low (n=9; 5%), whereas withdrawal rates were 34%. Based on Obermeyer's classification of degree of excavation correction, 35% had excellent/good, 25% fair, and 40% poor/worse results. When comparing patients with good/excellent results with those with unsatisfactory results, patients with good/excellent results had a longer treatment duration [19.0 (13.0; 28) months vs. 13.0 (6.5; 22.5) months, p 12 months.
Conclusion
One-third of patients in treatment with a vacuum bell achieved excellent or good outcomes in our cohort. Determinants of success included an initial pectus depth of 1.8 cm or less and a minimum length of treatment of 12 months.
Type of study
retrospective comparative study
Level of evidence
III