First experience of using a vacuum bell in the treatment of pectus excavatum in children

Abstract

BACKGROUND: To date, N.F. Filatov Childrens Hospital has great experience in the surgical correction of pectus excavatum in children. For 22 years, 1000 minimally invasive repair procedures of pectus excavatum were performed in the thoracic surgery department. Despite the satisfactory and excellent outcomes of the surgical correction of pectus excavatum, the search for alternative nonsurgical methods of treating this pathology continues. In world practice, a vacuum bell is used as a conservative treatment. However, its effectiveness and indications are still in question. AIM: To evaluate the first experience of using a vacuum bell in the treatment of pectus excavatum in children. MATERIALS AND METHODS: A vacuum bell is a device consisting of sight glass, silicone ring, and manual pump, lifting chest wall deformities through a vacuum. The device is selected individually depending on the growth and shape of the ventral surface of the chest. According to instructions, the vacuum bell should be used a minimum of 1 h per day. All patients underwent a standardized assessment of the results of treatment every 36 months: measuring the depth of deformation, visual treatment control, analysis of photo documentation, and questionnaires. RESULTS: In the N.F. Filatov Childrens Hospital from 2015 to 2021, treatment results of 35 children using vacuum bell for 636 months were analyzed. Patients were divided into two groups depending on the percentage of deformation correction. The first group included 23 (65.7%) patients, and the percentage of correction was 50%. The second group included 12 (34.3%) patients, and the percentage of correction was 50%. In these groups, the main differences in the age of treatment initiation, regularity of use, and time of daily use have influenced the results. In the first and second groups, the average ages were 8.7 2.69 and 13.7 3.56 years, and the average daily use times were 5.7 2.04 and 3.6 1.61 h/day, respectively. CONCLUSIONS: Vacuum bell therapy is an effective and safe method for correcting pectus excavatum in children, and in some cases, it can be an alternative to surgical treatments.