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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
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膀回流症のための尿路ステント:国立外科品質改善プログラム-小児科のデータ分析
Joan Marie Flor1, Maryam Noparast1, Kourosh Afshar1
1Department of Urologic Sciences, University of British Columbia, British Columbia Children's Hospital, Vancouver, BC, Canada.
まとめ
膀回流 (VUR) 手術中の尿路ステントは,緊急診察の頻度,再入院,長期の入院に関連しています. ステントの選択的な使用は,短期的な結果を改善する可能性があります.
科学分野:
- 小児泌尿器科
- 手術 結果 研究
背景:
- 膀回流症 (VUR) は,手術を必要とする子供の一般的な疾患です.
- 尿路再移植はVURの標準的な手術です.
- この手順で尿道ステントの使用は一般的な慣行ですが,短期的な結果への影響については議論されています.
研究 の 目的:
- VURの尿路再植入時の尿路ステント置換と短期的な術後の結果との関連性を評価する.
- 小児VUR手術における尿管ステントと関連している特定の有害な結果を特定する.
主な方法:
- 国家外科品質改善プログラム-小児科 (NSQIP-P) データベースの遡及分析.
- VURのために尿管再植入を受けた4550人の小児患者を含む.
- 多変数ロジスティック,線形,負の二項回帰モデルを使用して,患者および外科的要因を制御した結果を分析した.
主要な成果:
- 尿路ステントは,緊急診療所への訪問率 (p=0. 0019) が著しく高かった.
- ステントは再入院 (p< 0. 0001) と手術後の尿路感染症 (p< 0. 0001) の増加と相関する.
- ステントを装着した患者は,入院期間が37%長く (p< 0. 0001) され,手術期間が31分長く (p< 0. 0001) なりました.
結論:
- VURに対する尿路再移植の際に尿路ステントを設置することは,短期間の不良な術後の結果と関連しています.
- この発見は,VUR再移植の手続きにおいて,尿路ステントの選択的使用の必要性を示唆している.
- 制限には,特定の手術データ (再植入型,ステント型) と長期的な成功率が含まれます.
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