Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-01-06 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1359719

Michael F Levidy, Amanda Azer, Jasmine Shafei, Nivetha Srinivasan, Jasmine Mahajan, Shivani Gupta, George Abdelmalek, Krittika Pant, Kunj Jain, Yash Shah, Zheshi Zheng, Johnny Chuieng-Yi Lu, Tommy Nai-Jen Chang, Alice Chu, Aleksandra McGrath

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引用次数: 0

Abstract

Background: We analyzed trends in age at surgery and surgical approach over time and geography.

Methods: We performed a systematic review according to PRISMA-IPD guidelines to include individual patient data. Collected data included age at surgery, location of surgery, and surgical approach. The surgical approach was independently categorized as the exploration of the brachial plexus (EBP) or nerve transfer without root exploration (NTwoRE). EBP was defined as exploring the brachial plexus in the supraclavicular fossa and applying a choice of coaptation procedures. NTwoRE included those sourcing donor nerves from, or entirely occurring outside of the plexus without exploring the root of the brachial plexus.

Results: Regression analysis of age at surgery 1985-2020 showed that age at BPBI surgery is rising (p < 0.05). Surgery was performed at a younger age in patients from Europe (7.06 ± 7.77 months) and Asia (7.58 ± 5.33 months) than those from North America (10.44 ± 5.01 months) and South America (14.71 ± 4.53 months) (p < 0.05). NTwoRE was more common in North America (37%) and least common in Europe (12%). Age at EBP was 7.2 ± 5.77 months, and age at NTwoRE was 15.85 ± 13.18 months (p < 0.05). The incidence of NTwoRE is increasing time.

Conclusions: Age at NBPP surgery is increasing over time. Regional differences exist in age at NBPP surgery. Approaches to NBPP surgery that avoid exploration of BP roots are becoming more popular. Age at EBP is lower than age at NTwoRE.

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新生儿臂丛神经麻痹手术入路的全球趋势：系统回顾。

背景：我们分析了手术年龄和手术入路随时间和地理的变化趋势。方法：我们根据PRISMA-IPD指南进行了系统评价，包括个体患者数据。收集的资料包括手术年龄、手术部位和手术入路。手术入路独立分为臂丛探查（EBP）或神经转移不探查（ntwear）。EBP被定义为探索锁骨上窝的臂丛，并应用选择的复位程序。ntwear包括那些供体神经来自臂丛或完全发生在臂丛外而不探索臂丛根的神经。结果：1985-2020年手术年龄回归分析显示，BPBI手术年龄呈上升趋势（p p p）。结论：NBPP手术年龄随时间的推移而增加。NBPP手术的年龄存在地区差异。避免探查BP根的NBPP手术方法正变得越来越流行。EBP的年龄低于ntwear的年龄。

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

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.