Treatment of pectus excavatum in children with the vacuum bell: a literature review
- Authors: Shominova A.O.1, Mitupov Z.B.1,2, Razumovskij A.Y.1,2, Nurik V.I.1, Gincu G.S.3, Pavlov A.A.4
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Affiliations:
- The Russian National Research Medical University named after N.I. Pirogov
- Filatov N.F. Children’s City Hospital
- Nicolae Testemicanu State Medical and Pharmaceutical University
- Republican Children`s Clinical Hospital
- Issue: Vol 28, No 2 (2024)
- Pages: 194-205
- Section: SCIENTIFIC REVIEWS
- Submitted: 31.03.2023
- Accepted: 23.05.2023
- Published: 30.05.2024
- URL: https://jps-nmp.ru/jour/article/view/644
- DOI: https://doi.org/10.17816/ps644
- ID: 644
Cite item
Abstract
Pectus excavatum is the most common type of chest deformation with the sunken sternum and adjacent parts of the ribs. In recent decades, approach to the management of this pathology has changed, in many respects due to Eckhart Kloba’s invention a vacuum bell in 1992, which can be used both intraoperatively and as a non-invasive monotherapy.
Literary sources were searched in PubMed, Web of Science, Scopus, Google Scholar, and Elibrary databases. The following keywords were used for search in the English literature: «pectus excavatum», «funnel chest», «vacuum bell», «vacuum chest wall lifter», «suction cup», «minimally invasive repair of pectus excavatum (MIRPE)», «intraoperative vacuum bell». In Russian-language literature sources, the key words were: “воронкообразная деформация грудной клетки», «консервативное лечение», «вакуумный колокол». More than 50 publications on this topic have been analyzed.
Patients of different age groups with pectus excavatum of varying severity were taken in the study. The effectiveness of treatment was mainly assessed by computed tomography measurements of deformity depth and the Haller index before and after treatment. Excellent correction results were achieved in 13.5–80% of patients with the vacuum bell. The authors have made an attempt to define how patient’s age, duration of treatment, pathology severity, and deformity type correlate with the effectiveness of vacuum bell treatment. The vacuum bell can also be used as a non-invasive lift of the sternum during Nuss thoracoplasty surgery.
Currently, there is no any unified tactics for the conservative management of patients with pectus excavatum, namely, unified indications, period of conservative treatment, and optimal patient’s age for vacuum bell application. In the available literature, there is no any criterion that could predict the success of conservative treatment; there are no follow-up data for more than 2 years. A more precise assessment of vacuum bell effectiveness in the treatment of patients with pectus excavatum should be confirmed in longer studies with a larger number of cases.
Full Text
About the authors
Alena O. Shominova
The Russian National Research Medical University named after N.I. Pirogov
Author for correspondence.
Email: alshominova@icloud.com
ORCID iD: 0000-0001-7205-0937
Россия, 1 Ostrovityanova street, 117887 Moscow
Zorikto B. Mitupov
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children’s City Hospital
Email: zmitupov@mail.ru
ORCID iD: 0000-0002-0016-6444
SPIN-code: 5182-1748
MD, Dr. Sci. (Medicine), Professor
Россия, 1 Ostrovityanova street, 117887 Moscow; 15 Sadovaya-Kudrinskaya street, 123001 Moscow; MoscowAleksander Yu. Razumovskij
The Russian National Research Medical University named after N.I. Pirogov; Filatov N.F. Children’s City Hospital
Email: 1595105@mail.ru
ORCID iD: 0000-0002-9497-4070
SPIN-code: 3600-4701
MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences
Россия, 1 Ostrovityanova street, 117887 Moscow; 15 Sadovaya-Kudrinskaya street, 123001 Moscow; MoscowVera I. Nurik
The Russian National Research Medical University named after N.I. Pirogov
Email: vera.nurik@mail.ru
ORCID iD: 0009-0002-6025-1357
SPIN-code: 1431-2990
MD, Cand. Sci. (Medicine)
Россия, 1 Ostrovityanova street, 117887 MoscowGeorge S. Gincu
Nicolae Testemicanu State Medical and Pharmaceutical University
Email: laritei@mail.ru
ORCID iD: 0000-0003-4350-5423
MD, Dr. Sci. (Medicine)
Россия, ChisinauAnatoliy A. Pavlov
Republican Children`s Clinical Hospital
Email: doctorpavlov@mail.ru
ORCID iD: 0000-0003-1709-646X
MD, Cand. Sci. (Medicine)
Россия, CheboksaryReferences
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