儿童尾炎:手术诊断和组织学诊断之间的相关性
Balazs Fadgyas1,2, Georgina Monostori3, Dorottya Ori4,5
1Department of Surgery and Traumatology, Heim Pál National Institute of Pediatrics, 86 Üllői Road, Budapest, 1089, Hungary. drfadgyasbalazs@gmail.com.
Pediatric surgery international
|October 4, 2024
概括
儿科外科医生和病理学家在诊断急性尾炎 (AA) 方面表现出强烈的共识. 在手术期间低估AA严重程度会增加并发症风险和住院时间.
科学领域:
- 儿科手术 儿科手术
- 手术病理学手术病理学
- 胃肠道疾病 胃肠道疾病
背景情况:
- 精确诊断急性尾炎 (AA) 对于儿童患者的适当治疗至关重要.
- 手术内评估和组织学发现之间的差异可能会影响患者的结果.
- 腹腔镜尾切除术 (LA) 和开放尾切除术 (OA) 是常见的手术方法.
研究的目的:
- 评估儿科急性尾炎手术和组织学发现之间的诊断差异.
- 为了比较结果,包括停留时间 (LOS) 和并发症,在腹腔镜尾切除术 (LA) 和开放尾切除术 (OA) 之间.
主要方法:
- 在2011年至2020年期间接受尾切除手术的儿科患者 (<18岁) 的回顾性观察队列研究.
- 操作外科医生的外科诊断与被分类为无并发症或复杂的组织学发现进行了比较.
- 对逗留时间 (LOS) 和并发症率的统计分析.
主要成果:
- 共有1444名儿科患者被纳入该研究.
- 在手术诊断和组织病理诊断之间观察到显著的强相关性和中等到实质性的一致性 (加权卡帕:0.633-0.639).
- 外科医生低估AA严重程度导致较长的LOS (4天) 与准确诊断 (3天) 相比 (p < 0.0001).
结论:
- 这项研究发现,与一些文献相反,儿科急性尾炎的手术内和组织病理学发现之间存在强烈的相关性和中等一致性.
- 复杂的AA病例在手术期间可以识别.
- 在手术期间未能准确评估AA严重程度与更高的并发症和长时间住院的可能性有关.
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