拉巴洛斯科比在儿童时期的尾切除术的结果与开放的尾切除术
Udo Rolle1, Wolf O Bechstein, Claus Fahlenbrach
1Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt/Main, Frankfurt/Main, Germany; Department of General, Visceral, Transplantation and Thoracic Surgery, University Hospital Frankfurt/Main, Frankfurt/Main, Germany; AOK Federal Association, Berlin, Germany; Institute for Quality Assurance and Transparency in Healthcare (IQTIG), Berlin, Germany; German Society of Surgery (DGCH), Berlin, Germany; Helios Kliniken, Division of Quality Management, Berlin, Germany; Department of General and Visceral Surgery, HELIOS Hospital Erfurt, Erfurt, Germany; Medical Service of the Health Insurance Fund Baden-Württemberg, Freiburg, Germany; AOK Research Institute (WIdO), Berlin, Germany.
在儿童中,腹腔镜尾切除术 (LA) 的并发症比老年儿童的开放手术 (OA) 少,但在最年轻的年龄组中,结果相似. 从LA转换为OA显著增加了重新运营的风险.
科学领域:
- 儿科手术 儿科手术
- 手术结果研究研究.
- 相对的有效性比较
背景情况:
- 尾切除术是一种常见的儿科手术手术.
- 有两种主要的手术方法:腹腔镜 (LA) 和开放式 (OA).
- 从LA转换为OA的手术内转换是影响结果的潜在因素.
研究的目的:
- 为了比较腹腔镜尾切除术 (LA) 与儿童的开放尾切除术 (OA) 的结果.
- 评估从LA转换为OA的手术内转换对手术结果的影响.
- 分析小儿尾切除术结果中的特定年龄差异.
主要方法:
- 对儿童和青少年 (2017-2019) 常规医疗保险数据 (AOK,德国) 的分析.
- 包括21541名接受尾切除术的患者,分为三个年龄组 (1-5,6-12,13-17岁).
- 用后勤回归分析评估90天内一般手术并发症和重复手术的情况.
主要成果:
- 整体并发症率为2.1%,重复手术率为1.8%.
- 在较小的儿童 (1-5岁:5.4%的并发症,4.4%的重复手术) 中观察到更高的并发症和重复手术率.
- 腹腔镜尾切除术 (LA) 在6至17岁的儿童中显示出比开放尾切除术 (OA) 更好的结果,但在1至5岁的儿童中表现相似. 从LA转换为OA显著增加了重新操作的风险 (OR 3.5-4.2).
结论:
- 腹腔镜尾切除术 (LA) 与6至17岁儿童的开放尾切除术 (OA) 相比,与更少的并发症和重复手术有关.
- 与OA相比,LA的好处在1-5岁儿童中不那么明显.
- 从LA转换为OA的手术内转换是造成不良结果的重要风险因素,包括重复手术.
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