Comprehensive management strategies for pediatric pectus excavatum: exploring rehabilitative and surgical approaches

INTRODUCTION: Pectus excavatum (PE) is a common congenital chest wall deformity that can impact physical and psychological health. Effective management often involves a combination of surgical and non-surgical treatments, including physiotherapy. This review aims to assess the current literature on rehabilitative approaches for adolescents and children with PE to identify elective treatments.EVIDENCE ACQUISITION: This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews, employing systematic database searches across MEDLINE, Cochrane Central, Scopus, and PEDro. A two-stage study selection was conducted, with disagreements resolved by a third reviewer. Data extraction followed a thematic synthesis approach, focusing on conservative and surgical treatments for pectus excavatum.EVIDENCE SYNTHESIS: The review included a diverse range of studies with varying methodologies and sample sizes. Physiotherapy, combined with conservative treatments like the vacuum bell, showed significant improvements in lung function, physical fitness, and quality of life. Surgical interventions, particularly the minimally invasive Nuss procedure, demonstrated effective long-term outcomes with early postoperative rehabilitation enhancing recovery. Accurate diagnosis and classification using tools like the Haller index and anthropometric index were critical for selecting appropriate treatments.CONCLUSIONS: Physiotherapy plays a crucial role in the management of PE, especially when combined with conservative treatments. Early postoperative rehabilitation following surgical interventions like the Nuss procedure significantly improves functional outcomes. However, there is a need for high-quality randomized controlled trials to establish definitive guidelines. A multidisciplinary approach, incorporating accurate diagnostic tools and tailored rehabilitative programs, is essential for optimizing treatment outcomes and improving the quality of life for adolescents and children with PE.