Aughtman Shelby, Hehman Charles, Janssen Letitia, Golden Jamie, Goretsky Michael J, Obermeyer Robert J
Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Department of Surgery, P.O. Box 1980, Norfolk, VA, 23501, United States.
Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Department of Surgery, P.O. Box 1980, Norfolk, VA, 23501, United States; Children's Hospital of the King's Daughters, 601 Children's Lane, Norfolk, VA, 23507, United States.
J Pediatr Surg. 2025 Mar;60(3):162020. doi: 10.1016/j.jpedsurg.2024.162020. Epub 2024 Oct 20.
To evaluate factors associated with excellent correction in pectus excavatum patients undergoing vacuum bell therapy (VBT).
A single-institution retrospective chart review was performed November 2012-April 2023 to assess corrections of patients who underwent VBT. Patient demographics, presentation, and results were collected. Excellent correction was defined as complete correction or >100 % improved from an average standard chest depth of 0.51 cm. Data are reported using odds ratio & confidence intervals; and paired t-test comparison. A p-value of <0.05 was regarded as significant.
VBT was utilized in 431 patients with 278 patients included and 153 excluded due to loss of follow-up or incomplete data. Of those included, 89 % were male. There were 31 patients with excellent corrections (11 %) and 247 non-excellent corrections. Initial chest depth < 1.5 cm and chest wall flexibility remain important predictors of positive outcome (p=0.008 and < 0.001, respectively). Excellent correction was statistically more likely in patients aged 8 to 12.9 (OR = 2.2, p = 0.039). Surgical correction following VBT was performed in only 15.5 % (42 of 278) of our patients, none of which were in the group with an excellent correction.
Excellent correction for pectus excavatum via VBT was achieved in a small proportion of patients, with improved outcomes in those initiating therapy at a younger age, with a mild defect, and with increased chest wall flexibility. These data may be used to help determine those more likely to achieve complete correction from a nonsurgical approach and guide decisions towards treatment methods.
