Efficacy and determinants of vacuum bell treatment in preschool children with pectus excavatum

Abstract

ObjectiveThe outcome of vacuum bell (VB) treatment for preschool patients with pectus excavatum (PE) is poorly understood. We aim to investigate the short-term treatment effect of VB with a three-dimensional scanner and assess the clinical and demographic factors that might influence treatment outcomes.MethodsWe conducted a chart review study to review the records of preschool patients with PE who received VB treatment in a tertiary hospital from January 1, 2021, through January 1, 2022. Demographic data and chest wall deformity assessments were recorded at follow-up, including the anterior chest wall depths and depth ratio (DR). The demographic and clinical factors influencing treatment outcomes were tested using a logistic regression model.Results139 patients who accepted vacuum bell treatment were included in the final study analysis, with a mean age of 4.6 years and a BMI of 14.9. Forty-three patients (30.9%) with a depth of less than 3 mm met the termination criteria and showed cosmetic results. The changes in depths (P < 0.001) and DR (P < 0.001) were statistically significant in 55 patients with three or four follow-ups. Multifactor logistic regression analysis showed that initial depth (OR 0.69, 95% CI 0.58–0.84, P < 0.001) and treatment period (OR 1.58, 95% CI 1.23–2.04, P < 0.001) were independent predictors of achieving complete correction.ConclusionVB is an effective treatment modality in preschool patients in the short-term follow-up, which is influenced by the depth of depression and the duration of treatment. However, further prospective studies are needed to confirm these results.