Determinants of success associated with vacuum bell treatment of pectus excavatum

Toselli, Luzia; Chinni, Emilio; Nazar-Peirano, Maximiliano; Vallee, Maxroxia; Sanjurjo, Daniela; Martinez, Jorge; Bellía-Munzón, Gastón

doi:10.1016/j.jpedsurg.2022.04.010

Cited by 14 publications

(9 citation statements)

References 20 publications

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“…These results that decreased initial depths and increased treatment periods are more likely to achieve excellent treatment outcomes also corroborate the findings of prior work by Toselli et al. ( 20 ). As mentioned above, the treatment outcome of VB may be influenced by many factors.…”

Section: Discussionsupporting

confidence: 90%

Efficacy and determinants of vacuum bell treatment in preschool children with pectus excavatum

Luo

Cheng²,

Miao³

et al. 2022

Front. Pediatr.

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ObjectiveThe outcome of vacuum bell (VB) treatment for preschool patients with pectus excavatum (PE) is poorly understood. We aim to investigate the short-term treatment effect of VB with a three-dimensional scanner and assess the clinical and demographic factors that might influence treatment outcomes.MethodsWe conducted a chart review study to review the records of preschool patients with PE who received VB treatment in a tertiary hospital from January 1, 2021, through January 1, 2022. Demographic data and chest wall deformity assessments were recorded at follow-up, including the anterior chest wall depths and depth ratio (DR). The demographic and clinical factors influencing treatment outcomes were tested using a logistic regression model.Results139 patients who accepted vacuum bell treatment were included in the final study analysis, with a mean age of 4.6 years and a BMI of 14.9. Forty-three patients (30.9%) with a depth of less than 3 mm met the termination criteria and showed cosmetic results. The changes in depths (P < 0.001) and DR (P < 0.001) were statistically significant in 55 patients with three or four follow-ups. Multifactor logistic regression analysis showed that initial depth (OR 0.69, 95% CI 0.58–0.84, P < 0.001) and treatment period (OR 1.58, 95% CI 1.23–2.04, P < 0.001) were independent predictors of achieving complete correction.ConclusionVB is an effective treatment modality in preschool patients in the short-term follow-up, which is influenced by the depth of depression and the duration of treatment. However, further prospective studies are needed to confirm these results.

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Section: Discussionsupporting

confidence: 90%

Efficacy and determinants of vacuum bell treatment in preschool children with pectus excavatum

Luo

Cheng²,

Miao³

et al. 2022

Front. Pediatr.

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“…Generally, contraindications for the use of the bell include coagulopathies, cardiopathies, some vasculopathies (Marfan syndrome, aortic aneurism, aortic root dilatation), and certain skeletal conditions (imperfect osteogenesis, osteoporosis, osteomalacia) as a result of the increase in bell-related complications and its potential repercussion on the previous pathology (5,6,12) .…”

Section: Discussionmentioning

confidence: 99%

“…The most important variables associated with a good repair include greater chest flexibility, which is associated to younger ages (≤ 11 years), less severe baseline sinking (≤ 1.5 cm), PE symmetry, and longer time of use of the VB (≥ 2 hours daily for > 12 consecutive months) (12,13,15,16) . Considering these variables, the patients that will benefit the most from this method are children close to puberty with moderate and symmetric PE, since they will have greater probability of success with shorter times of use (13) .…”

Section: Discussionmentioning

confidence: 99%

Treatment with pectus excavatum with vacuum bell during puberty

Arias¹,

Veiras²,

Iglesias³

et al. 2023

Cir Pediatr

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Objective. To assess the efficacy of the vacuum bell during puberty, according to the daily hours of use and treatment duration.Materials and methods. A retrospective analysis of patients treated with vacuum bell during puberty in the 2010-2021 period was carried out. Several variables were collected, including baseline and final sinking, repaired sinking expressed in cm and as a percentage from baseline sinking, daily hours of use, treatment duration, and complications. Patients were categorized into groups according to the daily hours of use (≤ 3 hours; 4-5 hours; ≥ 6 hours) and treatment duration (6-12 months; 13-24 months; 25-36 months; > 36 months), and they were statistically analyzed.Results. A total of 50 patients -41 male and 9 female-were studied, with a mean age of 12.5 years (range: 10-14 years). No significant differences among groups were observed in terms of baseline sinking, thoracic index, and final sinking. Repaired sinking did increase with the daily hours of use, with significant differences. Complications were mild. 3 patients withdrew from follow-up, and 5 out of the 25 patients who completed treatment achieved a good repair.Conclusions. To increase treatment efficacy, the vacuum bell should be used for 6 hours/day during puberty. This method is well-tolerated, causes mild complications, and may be an alternative to surgery in some cases.

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“…It should be noted that a general disadvantage of non-surgical therapy for pectus excavatum is patient non-compliance as a primary contributor to treatment failure. In most series, a substantial proportion of patients abandon treatment, for reasons that have yet to be studied systematically ( 71 ). Further research into long-term outcomes, including series with higher rates of treatment completion, is warranted to further define the ideal candidates and treatment regimen for vacuum bell therapy.…”

Section: Pectus Excavatum Managementmentioning

confidence: 99%

The management of pectus excavatum in pediatric patients: a narrative review

Scalise¹,

Demehri²

2023

Transl Pediatr

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Background and Objective: Pectus excavatum is the most common congenital chest wall anomaly, the hallmark of which is the caved-in appearance of the anterior chest. A growing body of literature exists surrounding methods of surgical correction, though considerable variability in management remains. The primary objectives of this review are to outline the current practices surrounding the care of pediatric patients with pectus excavatum and present emerging trends in the field that continue to impact the care of these patients.

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Determinants of success associated with vacuum bell treatment of pectus excavatum

Cited by 14 publications

References 20 publications

Efficacy and determinants of vacuum bell treatment in preschool children with pectus excavatum

Efficacy and determinants of vacuum bell treatment in preschool children with pectus excavatum

Treatment with pectus excavatum with vacuum bell during puberty

The management of pectus excavatum in pediatric patients: a narrative review

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