立即与延迟的手术治疗婴儿带内的密码症与内
Walter A Ramsey1, Carlos T Huerta1, Alexis K Jones2
1DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Journal of pediatric surgery
|October 20, 2023
概括
新生儿未下降的丸 (UT) 和 inguinal hernias (IH) 的早期手术修复没有任何优势. 推将手术推迟到6-12个月,因为立即干预不会改善结果,可能会增加切除术率.
科学领域:
- 儿科手术 儿科手术
- 新生儿护理 新生儿护理
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 隐形形症 (丸未下降) 通常在6-12个月时通过形形治疗来控制.
- 同时的 inguinal hernias (IH) 有时会促使立即进行手术修复 (orchiopexy和 inguinal hernia修复 - IHR).
- 在新生儿中,早期手术干预对于IH和UT联合的益处尚不清楚.
研究的目的:
- 评估立即手术修复与延迟修复对新生儿诊断出未下降丸 (UT) 和手足 (IH) 的结果.
主要方法:
- 使用全国再录取数据库 (2010-2014) 的回顾性比较研究.
- 确定的新生儿被诊断为IH和UT,按初始入院管理分层:即时IHR (修复) 或推迟IHR (推迟).
- 对比人口统计,结果和并发症,对国家估计进行加权结果.
主要成果:
- 分析了1306名新生儿 (64%为早产) 患有IH和UT;30%接受了立即的IHR.
- 在早产婴儿和具有先天性异常的婴儿中,立即修复更为常见.
- 修复和推迟组之间再接收率没有显著差异;修复组的瘤切除率更高. 推迟患者因并发症而重新入院的情况很小.
结论:
- 对于UT和IH的新生儿,立即手术修复与改善的结果没有关联.
- 推迟手术是安全的,因为监禁或肠道损害的再入院率很低.
- 早期的手术干预没有任何好处;建议在6-12个月后重新评估手术.
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