15 Years of Vacuum Bell Therapy for Pectus Excavatum: Long-term Outcomes and Influencing Factors

被引：0

作者：

van Braak, Hendrik ^{[1
]}

Beer, Sjoerd A. de ^{[1
]}

al Ghouch, Youssef ^{[1
]}

Zwaveling, Sander ^{[1
]}

Oomen, Matthijs W. N. ^{[1
]}

Heurn, L. W. Ernest van ^{[1
]}

Jong, Justin R. de ^{[1
]}

机构：

[1] Emma Kinderziekenhuis Amsterdam Univ, Dept Pediat Surg, Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

来源：

JOURNAL OF PEDIATRIC SURGERY | 2025年 / 60卷 / 02期

关键词：

Pectus excavatum; Vacuum bell therapy; Long-term outcomes; Influencing factors;

D O I：

10.1016/j.jpedsurg.2024.161891

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Background: Long-term results and factors affecting outcomes of vacuum bell therapy for pectus excavatum are relatively unknown. Methods: We conducted a retrospective study on patients (<18y) treated with vacuum bell therapy between May 2008 and October 2021. Primary outcome was treatment success; secondary outcomes were analysis of daily time spent on treatment, treatment duration, complications, long-term follow-up, treatment for patients awaiting a Nuss procedure, treatment for female patients, and factors affecting outcomes. Results: Of 259 patients treated with vacuum bell therapy, 18.9% (n = 49/259) were still being treated, 17.4% (n = 45/259) were lost to follow-up and 63.7% (n = 165/259) completed treatment, with a 52.1% (n = 86/165) success rate. Median follow-up was 64.0 months (interquartile range 48.0-87.0). More time spent daily on vacuum bell therapy, total treatment duration, and overnight use led to a higher success rate (P = 0.002, P < 0.001, P < 0.001 resp.). Complications (22.8%, n = 59/259) were minor, recurrence occurred in 2.3% (n = 2/86) of patients. Of the patients treated while awaiting a Nuss procedure, 26.7% (n = 4/15) no longer required the Nuss procedure. Breast growth made 39.3% (n = 11/28) of female patients quit treatment. Deeper deformities (P = 0.02, P = 0.009), flexible chest wall (P = 0.007) and symptomatic pectus excavatum (P = 0.02) resulted in lower success rates. Conclusions: Vacuum bell therapy is successful in up to 52.1% of patients. Overnight vacuum bell use and treatment while awaiting a Nuss procedure should be encouraged. Older patients with a stiff chest wall can be successfully treated with prolonged treatment. For female patients watchful waiting or early treatment, to prevent challenges during breast growth, is preferred. Level of evidence: Level II. (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

页数：7