{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:13:20Z","timestamp":1783008800004,"version":"3.54.5"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/open-government-licence\/version\/3\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A best evidence topic in thoracic surgery was written in accordance to a structured protocol. The question addressed was: \u2018In patients with a pectus excavatum deformity, is vacuum bell therapy (VBT) an effective treatment?\u2019 Altogether, 19 papers were found using the reported search of which 7 represented the best evidence to answer the clinical questions. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Numerous groups have demonstrated the utility of VBT in pectus excavatum; the largest series has followed up patients over 13\u2009years with sternal elevation of &gt;1\u2009cm being demonstrated in 105 patients. Initial age &lt;11, initial chest wall depth &lt;1.5\u2009cm and chest wall flexibility have all been associated with better outcomes. The effects of VBT have been confirmed on computed tomography scanning and intraoperatively to lift the sternum to facilitate retrosternal soft tissue dissection during the Nuss procedure. There was significant heterogeneity in the studies reviewed, in terms of patient age, selection criteria, the VBT protocol, length of follow-up time following completion of VBT and the metrics used to assess success of therapy. VBT is a safe therapy for treating pectus excavatum in a non-surgical conservative manner with few complications reported. However, the success of VBT is largely dependent on patient compliance and motivation. Permanence of correction after completion of VBT needs to be properly assessed through rigorous follow-up, and currently the success of correction, i.e. permanence, remains in the hands of the patient.<\/jats:p>","DOI":"10.1093\/icvts\/ivz082","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T04:16:12Z","timestamp":1551327372000},"page":"287-290","source":"Crossref","is-referenced-by-count":24,"title":["Is vacuum bell therapy effective in the correction of pectus excavatum?"],"prefix":"10.1093","volume":"29","author":[{"given":"Akshay J","family":"Patel","sequence":"first","affiliation":[{"name":"Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK"},{"name":"Department of Thoracic Surgery, Heartland\u2019s Hospital, UHB NHS Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, St. George\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,28]]},"reference":[{"key":"2019072505402306400_ivz082-B1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/S1569-9293(03)00191-9","article-title":"Towards evidence-based medicine in cardiothoracic surgery: best BETS","volume":"2","author":"Dunning","year":"2003","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2019072505402306400_ivz082-B2","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.ejcts.2006.01.025","article-title":"The vacuum bell for treatment of pectus excavatum: an alternative to surgical correction?","volume":"29","author":"Haecker","year":"2006","journal-title":"Eur J Cardiothorac Surg"},{"key":"2019072505402306400_ivz082-B3","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00383-010-2843-7","article-title":"The vacuum bell for conservative treatment of pectus excavatum: the Basle experience","volume":"27","author":"Haecker","year":"2011","journal-title":"Pediatr Surg Int"},{"key":"2019072505402306400_ivz082-B4","doi-asserted-by":"crossref","first-page":"440","DOI":"10.21037\/acs.2016.06.06","article-title":"Vacuum bell therapy","volume":"5","author":"Haecker","year":"2016","journal-title":"Ann Cardiothorac Surg"},{"key":"2019072505402306400_ivz082-B5","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.jpedsurg.2015.10.003","article-title":"Preliminary study of efficacy of cup suction in the correction of typical pectus excavatum","volume":"51","author":"Lopez","year":"2016","journal-title":"J Pediatr Surg"},{"key":"2019072505402306400_ivz082-B6","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpedsurg.2018.02.088","article-title":"Nonoperative management of pectus excavatum with vacuum bell therapy: a single center study","author":"Obermeyer","year":"2018","journal-title":"J Pediatr Surg [Internet]"},{"key":"2019072505402306400_ivz082-B7","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.jpedsurg.2004.11.033","article-title":"The vacuum chest wall lifter: an innovative, nonsurgical addition to the management of pectus excavatum","volume":"40","author":"Schier","year":"2005","journal-title":"J Pediatr Surg"},{"key":"2019072505402306400_ivz082-B8","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jpedsurg.2017.04.016","article-title":"The Vacuum Bell device as a sternal lifter: an immediate effect even with a short time use","volume":"53","author":"Togoro","year":"2018","journal-title":"J Pediatr Surg"},{"key":"2019072505402306400_ivz082-B9","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1089\/lap.2012.0030","article-title":"Intraoperative use of the vacuum bell for elevating the sternum during the Nuss procedure","volume":"22","author":"Haecker","year":"2012","journal-title":"J Laparoendosc Adv Surg Tech A"}],"container-title":["Interactive CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/icvts\/article-pdf\/29\/2\/287\/28998480\/ivz082.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,25]],"date-time":"2019-07-25T09:40:56Z","timestamp":1564047656000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/29\/2\/287\/5421226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,28]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,3,28]]},"published-print":{"date-parts":[[2019,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivz082","relation":{},"ISSN":["1569-9285"],"issn-type":[{"value":"1569-9285","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,8]]},"published":{"date-parts":[[2019,3,28]]}}}