欧洲儿科外科医生协会关于在治疗隐睾时遵守EAU/ESPU指南的调查。

IF 1.5 3区 医学 Q2 PEDIATRICS
European Journal of Pediatric Surgery Pub Date : 2024-10-01 Epub Date: 2023-11-28 DOI:10.1055/s-0043-1777338
Ophelia Aubert, Hind Zaidan, Hanna Garnier, Amulya K Saxena, Salvatore Cascio
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引用次数: 0

摘要

简介:本研究的目的是评估欧洲泌尿外科协会(EAU)/欧洲儿科泌尿外科学会(ESPU) 2016年隐睾(UDT)治疗指南的依从性。材料和方法:于2023年向欧洲儿科外科医生协会(EUPSA)的成员发送了一份在线问卷。结果:157名会员在12个月和18个月前分别有46%和44%的人进行了兰花切除术。总的来说,92%的人建议对收缩性睾丸进行保守治疗,58%的人建议密切随访。对于摸不到的睾丸,78%的人倾向于腹腔镜检查,18%的人倾向于超声检查。如果在腹腔镜检查中发现窥视睾丸,76%的患者会进行单阶段睾丸切除术。在高睾丸的情况下,分期手术是首选(84%)。对盲终止精管的处理是不同的,大多数结束手术,然后探查腹股沟管和切除睾丸结节,选择性地固定对侧睾丸。只有少数人推荐激素治疗来提高双侧UDT的生育潜力。大多数(59%)讨论了青春期后男孩UDT的睾丸切除。此外,77%的人声称遵循EAU/ESPU指南。不了解指南是不遵守指南的最常见原因。研究发现,国际指南对临床实践影响最大;然而,个人经验和制度实践似乎起着重要作用。结论:欧亚经济联盟/欧洲经济政策股准则的大多数建议正在得到欧亚经济联盟成员的遵守;然而,个人和机构的实践影响决策。双侧UDT的激素治疗,睾丸消失的管理,青春期后男孩的UDT可以得到改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
European Paediatric Surgeons' Association Survey on the Adherence to EAU/ESPU Guidelines in the Management of Undescended Testes.

Introduction:  The aim of this study was to assess the adherence to the European Association of Urology (EAU)/European Society for Pediatric Urology (ESPU) 2016 guidelines in the management of undescended testes (UDT).

Materials and methods:  An online questionnaire was sent in 2023 to members of the European Paediatric Surgeons' Association (EUPSA).

Results:  Among 157 members, 46 and 44% perform orchidopexy before 12 and 18 months, respectively. In total, 92% recommend conservative management of retractile testes and 58% offer close follow-up. In case of nonpalpable testes, 78% favor laparoscopy and 18% ultrasonography. If a peeping testicle is identified at laparoscopy, 76% perform a single-stage orchidopexy. In case of a high testicle, a staged procedure is preferred (84%). Management of blind-ending spermatic vessel is heterogenous with a majority ending the operation, followed by exploration of the inguinal canal and removal of the testicular nubbin with optional fixation of the contralateral testis. Only a minority recommends hormonal therapy to improve fertility potential in bilateral UDT. A majority (59%) discuss testis removal in UDT in postpubertal boys. In addition, 77% declare following the EAU/ESPU guidelines. Unawareness of guidelines was the most common reason cited for nonadherence. International guidelines were found to have the greatest influence on clinical practice; however, personal experience and institutional practice seem to play an important role.

Conclusion:  Most recommendations of the EAU/ESPU guidelines are being followed by EUPSA members; however, personal and institutional practice impact decision making. Hormonal therapy in bilateral UDT, management of vanishing testes, and UDT in postpubertal boys could be improved.

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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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