尿道下裂修补术后随访期间的累积再手术率。

IF 3.7 2区医学 Q1 UROLOGY & NEPHROLOGY

BJU International Pub Date : 2024-09-03 DOI:10.1111/bju.16519

Annaleena Anttila, Tuija Lahdes-Vasama, Niklas Pakkasjärvi, Seppo Taskinen

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引用次数: 0

摘要

目的在一家三级儿科泌尿外科中心评估尿道下裂修复术后再次手术的累积率，并评估长期手术效果：对 1991 年至 2003 年间出生的 293 名接受尿道下裂手术的男孩进行了回顾性分析。研究包括 274 名患者：其中远端尿道下裂 165 例，中轴尿道下裂 34 例，近端尿道下裂 75 例。采用卡普兰-梅耶法评估再次手术数据：结果：初次手术的中位年龄为1.3岁，中位随访时间为14.4年。总的再手术率为 48.2%，其中约有一半的问题是在术后 3 个月内发现的。再次手术的风险与尿道下裂的严重程度相关，5年和15年再次手术的风险分别为39.3%和51.8%。该研究的局限性包括其回顾性和手术技术与现行标准的差异：结论：尿道下裂修复术后计划外再次手术的风险很大，而且随着原发病的严重程度而增加。结论：尿道下裂修复术后计划外再次手术的风险很大，且随着原发病的严重程度而增加。这突出表明需要延长随访时间，并与患者及其家属进行有效沟通，使其了解需要进行多次手术以获得最佳治疗效果的可能性。

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Cumulative re-operation rates during follow-up after hypospadias repair

Objective

To assess the cumulative rates of re-operations after hypospadias repair and evaluate long-term surgical outcomes at a tertiary paediatric urology centre.

Patients and Methods

Retrospective analysis of 293 boys born between 1991 and 2003 undergoing hypospadias surgery was conducted. The study included 274 patients: 165 with distal, 34 with midshaft, and 75 with proximal hypospadias. Kaplan–Meier methods were used to evaluate the re-operation data.

Results

The median age at primary surgery was 1.3 years, with a median follow-up of 14.4 years. The overall re-operation rate was 48.2%, with approximately half of the problems detected within the first 3 months after surgery. The risk of re-operation was correlated with hypospadias severity, with 5- and 15-year re-operation risks at 39.3% and 51.8%, respectively. Limitations of the study include its retrospective nature and variations in surgical techniques from current standards.

Conclusion

There is a significant risk of unplanned re-operations following hypospadias repair, increasing with the severity of the original condition. This underscores the need for extended follow-up and effective communication with patients and their families about the likelihood of requiring multiple surgeries for optimal outcomes.

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来源期刊

BJU International 医学-泌尿学与肾脏学

CiteScore

9.10

自引率

4.40%

发文量

262

审稿时长

1 months

期刊介绍： BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.