Fundación Hospitalaria Mother and Child Medical Center, Av. Crámer 4602. Capital Federal, Buenos Aires, Argentina C1429AKL.
Fundación Hospitalaria Mother and Child Medical Center, Av. Crámer 4602. Capital Federal, Buenos Aires, Argentina C1429AKL.
J Pediatr Surg. 2022 Nov;57(11):550-554. doi: 10.1016/j.jpedsurg.2022.04.010. Epub 2022 Apr 22.
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.
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.
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<0.0001], and lower initial pectus depth [1.6 (1.2; 2.0) cm, vs. 2.0 (1.5; 2.6) cm, p = 0.001]. Using ROC curves, the best determinants of success were an initial pectus depth ≤ 1.8 cm and a length of treatment > 12 months.
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.
retrospective comparative study LEVEL OF EVIDENCE: III.
背景/目的：我们对接受真空钟治疗的大量漏斗胸患者进行了研究，探讨了成功的决定因素，并比较了满意组和不满意组的结果。
这是一项 2013 年 5 月至 2020 年 1 月在单中心进行的回顾性病例对照研究，纳入了接受真空钟治疗的漏斗胸患者。我们根据数据登记截止时的状态（随访、退出、完全矫正、失败）以及 Obermeyer 漏斗胸矫正程度分类对患者进行分类。使用受试者工作特征曲线计算成功的决定因素。
共纳入 186 例患者。17%的患者达到完全矫正，45%的患者仍在随访中。失败率较低（n=9；5%），而退出率为 34%。根据 Obermeyer 漏斗胸矫正程度分类，35%的患者结果为优/良，25%的患者结果为可/差，40%的患者结果为差/更差。与结果不满意的患者相比，结果满意的患者治疗时间更长[19.0（13.0；28）个月比 13.0（6.5；22.5）个月，p<0.0001]，初始胸壁凹陷深度更低[1.6（1.2；2.0）cm 比 2.0（1.5；2.6）cm，p=0.001]。使用 ROC 曲线，成功的最佳决定因素为初始胸壁凹陷深度≤1.8cm 和治疗时间>12 个月。
在我们的队列中，接受真空钟治疗的患者中有三分之一达到了优秀或良好的效果。成功的决定因素包括初始胸壁凹陷深度为 1.8cm 或更小以及至少 12 个月的治疗时间。
回顾性比较研究 证据等级：III 级
