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

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. (C) 2018 Elsevier Inc. All rights reserved.