Surgical versus Vacuum Bell Therapy for the Correction of Pectus Excavatum: A Comparison of 1-Year Treatment Outcomes

Abstract

Background The purpose of this study was to compare 1-year clinical outcomes between patients who underwent a Nuss operation or vacuum bell therapy and to present vacuum bell therapy as a possible alternative treatment modality for patients who prefer non-surgical correction of pectus excavatum. Methods We conducted a retrospective review of pectus excavatum patients who had undergone vacuum bell therapy for more than 1 year and examined patients who had undergone Nuss bar removal more than 1 year previously. The treatment outcomes were evaluated by comparing changes in the Haller index before and after treatment in both patient groups. Results We included 57 patients in this study and divided them into 2 groups according to the type of treatment received. Both groups showed no significant difference in the post-treatment Haller index after 1 year of follow-up, although the Nuss operation group showed a greater change in the Haller index than the vacuum bell group. Conclusion Although the Nuss operation is a well-established and effective treatment of choice to correct pectus excavatum, vacuum bell therapy showed comparable outcomes and could become an alternative treatment modality for select patients who prefer non-invasive treatment.

Treatment with pectus excavatum with vacuum bell during puberty

“…It is recommended to start with two or three 15-to 60-minute daily sessions for 4-6 weeks. This time will be subsequently increased, depending on the patient's tolerance and motivation (6,9,14) . A treatment initiation protocol has been recently published, with a gradual increase in time and pressure, which is controlled with a measuring device coupled to the VB -a vacuum gauge.…”

“…The bell should not be regarded as a substitute for surgery (Nuss procedure), which allows for complete repair in all PE types and is the treatment of choice in severe cases (5,9) . Nevertheless, it can be an alternative in cases of moderate PE -where it can prevent an increase in severity and allow for sufficient repair to avoid surgery-and in patients with severe PE refusing surgery (13,14) . Since PE improvement following VB treatment primarily occurs in the first 6-12 months, unsatisfactory results after 12 months could also be considered an indication for surgery (5,19) .…”

Efficiency of non-operative management for pectus deformities in children using an X-ray-free protocol

“…The widespread use of non-operative devices enables management of severe as well as less severe forms. A vacuum bell can be proposed for children with PE, as its efficiency has been reported to be similar to that of surgical procedures, at least for mild forms [ 5 ]. PC can be treated with a thoracic bracelet and provides very satisfactory results.…”

“…It is well known that a non-irradiant protocol is preferable, but magnetic resonance imaging (MRI) is sometimes difficult to access. That is why chest computed tomography or chest X-rays continue to be performed sometimes [ 5 , 14 ].…”

The use of vacuum bell therapy for the treatment of pectus excavatum in children of the younger group: the dynamics of changes in echocardiography

“…Такі вади серця часто виявляються випадково під час рент-генографії або ультразвукового дослідження (УЗД) грудної клітки з причин, не пов'язаних із проблемами серця, і не викликають жодних клінічних проявів. Але вони можуть прогресувати одночасно з ускладненням основного захворювання -деформації грудної клітки [5]. Завдання полягало у виявленні патологічних змін, адже, за даними авторів, відхилення можуть сягати до 60% [9].…”