Pectus excavatum (PE), also referred to as “ funnel chest”, is most often treated with surgical intervention, despite the availability of conservative options. The objective of this study was to evaluate the evidence on the efficacy of conservative (non-surgical) management in improving the severity of PE in pre-pubertal and adolescent children. A systematic search was undertaken, utilizing four electronic databases: Academic Search Premier, Medline, PubMed, and Web of Science. English language studies published between 2010 and 2020 in which children with PE were treated with conservative approaches were included. The search yielded 295 studies; elimination of duplicates resulted in a remaining 155 articles. Records were screened by abstracts and titles for publication date, age range, and publication language. Two articles remained. An additional article was removed, as full text was not available for review. A single article remained. The article examined the effects of the vacuum bell device on 31 subjects with PE ranging from 6-21 years old. Results showed improvements in Haller Index and/or depth measurements. The surviving article’s quality was assessed with the MINORS scale (11 of 16) and risk of bias was assessed using the ROBINS-I. Most (5 of 7) risk of bias items were rated as “low”, but bias in classification of interventions was considered “serious”. The limited evidence emphasizes the need for high quality studies evaluating the effectiveness of conservative approaches to the management of PE.
Carlson, Mckenze, "When compared to surgery, is conservative (non-surgical) management effective in improving the severity of pectus excavatum in children? A Systematic Review." (2021). IdeaFest. 424.