Preoperative determinants of normative postoperative recovery rate following minimally invasive repair of pectus excavatum.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-11-15 DOI:10.1007/s00383-024-05889-5

Michela Carter, Austin R Chen, J Benjamin Pitt, Rui Hua, Arianna Edobor, Soyang Kwon, Seth D Goldstein, Hassan M K Ghomrawi, Fizan Abdullah

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引用次数: 0

Abstract

Purpose: Recovery after minimally invasive repair of pectus excavatum (MIRPE) is prolonged. The purpose of this prospective study was to enhance our understanding of post-MIRPE recovery by following patients' recovery through postoperative day (POD) 60 using wearable devices and determine if recovery rate is impacted by PE severity and preoperative physical activity (PA) level.

Methods: Children ≤ 18 years who underwent MIRPE with cryoablation between 8/2023 and 1/2024 wore a Fitbit™ for ≥ 3 days preoperatively to determine preoperative PA and through POD 60. The recovery trajectory, defined by postoperative daily step count divided by mean preoperative daily step count, was fit by power function through POD 60 among patients with uncomplicated recovery. Subgroup analyses were performed to compare recovery by PE severity and preoperative PA level.

Results: Sixteen patients met criteria (68.8% male, mean [SD] age 15.4 [1.6] years). Recovery trajectory analysis demonstrated recovery on POD 60 was 84.8% (95CI 79.0-90.6%). On subgroup analysis, patients with Correction Index > 40% and preoperative mean steps/day ≥ 10,000 had faster recovery.

Conclusions: Patients undergoing MIRPE with cryotherapy who are more active preoperatively or have higher Correction Indices were found to have accelerated recovery trajectories. These results may provide insight for preoperative counselling and interventions to optimize post-MIRPE recovery.

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微创修复胸大肌后术后正常恢复率的术前决定因素。

目的：胸大肌微创修复术（MIRPE）后的恢复期较长。这项前瞻性研究旨在通过使用可穿戴设备跟踪患者术后第 60 天（POD）的恢复情况，加深我们对 MIRPE 术后恢复情况的了解，并确定恢复率是否会受到 PE 严重程度和术前体力活动（PA）水平的影响：方法：在 2023 年 8 月 8 日至 2024 年 1 月 1 日期间接受冷冻消融术 MIRPE 的 18 岁以下儿童在术前≥ 3 天佩戴 Fitbit™，以确定术前 PA 和 POD 60。恢复轨迹由术后每日步数除以术前平均每日步数定义，通过幂函数拟合了无并发症恢复患者在 POD 60 期间的恢复轨迹。根据 PE 严重程度和术前 PA 水平对恢复情况进行了分组分析比较：结果：16 名患者符合标准（68.8% 为男性，平均 [SD] 年龄为 15.4 [1.6] 岁）。康复轨迹分析显示，POD 60 的康复率为 84.8%（95CI 79.0-90.6%）。在亚组分析中，矫正指数大于 40% 和术前平均步数/天≥ 10,000 步的患者恢复更快：结论：接受 MIRPE 和冷冻疗法的患者中，术前活动量较大或矫正指数较高的患者恢复速度较快。这些结果可为优化 MIRPE 术后恢复的术前咨询和干预提供启示。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor