局限性筋膜切除术与经皮针式筋膜切开术治疗杜普伊特伦氏病的耐久性对比。

IF 3.2 2区 医学 Q1 SURGERY
Plastic and reconstructive surgery Pub Date : 2024-11-01 Epub Date: 2024-01-30 DOI:10.1097/PRS.0000000000011322
Bente A van den Berge, Fatuma M A Omar, Paul M N Werker, Zhuozhao Zhan, Edwin R van den Heuvel, Dieuwke C Broekstra
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引用次数: 0

摘要

背景:杜普伊特伦氏病(Dupuytren's disease,DD)患者大多通过经皮穿刺针筋膜切开术(PNF)或局限性筋膜切除术(LF)进行手术治疗,但缺乏再治疗时间间隔的数据。我们的目的是估算经皮穿刺针筋膜切开术(PNF)和有限筋膜切除术(LF)治疗后一定时间内再治疗的风险:我们使用了一项 DD 病程队列研究中仅接受过 PNF 或 LF 治疗的参与者的数据。我们的主要结果指标是 DD 再治疗的时间。在分析中,我们将性别、首次治疗时的年龄以及是否有一级亲属患有 DD 作为混杂因素。我们采用双变量伽马虚弱模型估算了PNF和LF治疗后1、3、5、10和20年内再治疗的风险:结果:PNF治疗后的再治疗时间明显短于LF治疗后的再治疗时间(Wald检验7.56,p结论:我们的研究结果表明,接受 PNF 治疗的患者再治疗的风险更高。这项研究的结果将有助于在未来提供有关治疗耐久性的个性化信息,从而改善有关预期再治疗需求的患者咨询。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment Durability of Limited Fasciectomy versus Percutaneous Needle Fasciotomy for Dupuytren Disease.

Background: Patients with Dupuytren disease (DD) are mostly surgically treated by percutaneous needle fasciotomy (PNF) or limited fasciectomy (LF), but data on time intervals to retreatment are lacking. The authors aimed to estimate the risk of retreatment within certain time periods after treatment with PNF and LF.

Methods: The authors used data of participants of a cohort study on the course of DD who were treated only with PNF or LF. The primary outcome measure was time to retreatment of DD. The authors included sex, age at first treatment, and having a first-degree relative with DD as confounders in our analysis. A bivariate gamma frailty model was applied to estimate the risk of retreatment within 1, 3, 5, 10, and 20 years after treatment with PNF and LF.

Results: The time to retreatment was significantly shorter after treatment with PNF than after LF (Wald test statistic, 7.56; P < 0.001). The estimated 10-year risk of retreatment for men who underwent their first treatment at a younger age and with a first-degree relative with DD was 97% after PNF and 32% after LF. The estimated 10-year risk for women who underwent their first treatment at an older age without a first-degree relative with DD was 20% after PNF and 6% after LF.

Conclusions: The results show that the patients treated with PNF have a higher risk of retreatment. The results of this study could contribute to individualized information on the treatment durability in the future, which would improve patient counseling about the expected retreatment needs.

Clinical question/level of evidence: Therapeutic, III.

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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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