WOFAPS 2025 8th World Congress of Pediatric Surgery

Alena Shominova, Alexander Razumovsky, Zorikto Mitupov, Vlada Snegireva, Victor Rachkov

Pirogov Russian National Research Medical University, Moscow, Russia

Objective: To evaluate the effectiveness of the use of vacuum bell (VB) in the treatment of pectus excavatum.

Methods: This nonoperative method has been used since 2017. During which time more than 220 patients have been treated using VB. The study included 56 children. The inclusion criteria were age from 3 to 17 years, the presence of chest CT before and after treatment, and a duration of use VB of more than 12 months. The division of patients into groups was based on a point scale, which took into account changes in both the external depth of deformation and the percentage of correction of CT indicators.

Results: Group 1 with good results included 30 patients (53.6%), whose deformity correction percentage was >50, group 2 included 26 patients (46.4%), whose deformity correction was <50%. The effectiveness of treatment with a VB largely depended on the duration of daily use (Me in group 1 - 8 hours, in group 2 - 5 hours, p<0.001), regular exercise (in group 1 n=22 (73.3%), in group 2 n=9 (34.6%), p=0.004) and the severity of pectus excavatum (I-II degree in group 1 n=16 (53.3%), in group 2 n=6 (23.1%), p=0.021). There was no statistically significant difference in the age at which treatment began in the two groups (p=0.369). The VB is ineffective in girls with developed mammary glands with asymmetrical deformations due to the technical impossibility of installing the VB.

Conclusions: VB is an effective nonoperative method of treating pectus excavatum in patients with shallow symmetrical forms of deformities who regularly engage in sports. Treatment with VB is possible in children of different age groups and can also be an alternative for patients who wish to avoid surgical treatment.