Dynamic versus standard vacuum therapy for pectus excavatum: A comparative study of short-term treatment outcomes

Vacuum bell therapy is increasingly used as a nonoperative treatment for mild-to-moderate pectus excavatum (PE). However, evidence comparing different vacuum systems remains limited. In this study, we compared the short-term outcomes of dynamic vacuum therapy (DVT) and standard vacuum therapy (SVT) as primary nonoperative treatment approaches for PE.

This retrospective comparative cohort study included 78 patients with PE treated with vacuum therapy between 2024 and 2026, of whom 38 received DVT and 40 received SVT. Deformity depth was measured at baseline and again at 6 months. The primary outcomes were absolute improvement in deformity depth, complete or near-complete correction (residual deformity depth ≤0.5 cm), a marked response (reduction of ≥1 cm from baseline), treatment continuation, patient satisfaction, and device-related adverse events.

Patients in the DVT group were older than those in the SVT group (p = 0.009) and had greater baseline deformity depth (2.01 ± 0.58 vs. 1.43 ± 0.60 cm, p < 0.001). Mean correction at 6 months was similar between the two groups (p = 0.184). Complete or near-complete correction was more common in the SVT group. In contrast, a reduction of ≥1 cm was more common in the DVT group (47.4% vs. 25.0%, p = 0.040; OR, 2.70; 95% CI, 1.04-7.04). Treatment discontinuation occurred only in the SVT group (0.0% vs. 15.0%, p = 0.026). Patient satisfaction was similar between groups. Skin-related complaints were more frequent with DVT, although all adverse events were minor.

Both systems provided short-term improvement in PE. SVT more often achieved a residual depth ≤0.5 cm, likely reflecting lower baseline severity, whereas DVT showed a higher unadjusted ≥1 cm response rate and better treatment continuation. These findings should be interpreted cautiously because of baseline differences between groups and the absence of full confounder adjustment. Prospective studies are needed to confirm whether DVT provides a sustained clinical advantage.