Journal of pediatric surgery最新文献_第9页

Short-term Postoperative Complications of Lymphatic Malformation Surgical Excision: A 20-Year Institutional Review 淋巴畸形手术切除的短期术后并发症：20年的机构回顾。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-02 DOI: 10.1016/j.jpedsurg.2024.162146

Olivia A. Keane , MaKayla L. O'Guinn , Sarah Adams , Erin Delfosse , Sara Kreimer , Jessica Lee , Joseph Miller , Mary Timbang , Gabriel Gomez , Dean Anselmo

Objective

To evaluate outcomes and postoperative complications following surgical resection of lymphatic malformations (LMs) at a single multidisciplinary vascular anomalies center.

Methods

A single-center retrospective review of all patients ≤21 years old who underwent surgical resection of a lymphatic malformation at a quaternary referral center with a multidisciplinary vascular anomalies team from 2004 to 2024. Data pertaining to postoperative outcomes and treatments was abstracted.

Results

A total of 109 surgical procedures were included and examined. The most common 30-day postoperative complications included: seroma (18.3 %), superficial surgical site infection (18.3 %), and wound dehiscence (12.8 %), with lower rates of nerve palsy/injury (5.5 %), lymphedema (2.8 %), hematomas (3.7 %), and abscesses (4.6 %). An interventional radiology procedure within 30-days postoperatively was required for management of seroma in 8 patients (7.3 %), while 7 (6.4 %) patients required reoperation. Among patients who underwent attempted complete resection, recurrence of the LM was documented in 32.0 % (16/50). Subjective quality of life improvement was noted in 69.7 %. There was no difference in incidence of postoperative complications reported in patients who underwent preoperative sclerotherapy vs those that did not (p = 0.980).

Conclusion

Seroma and surgical site infection were the most reported short-term postoperative complications followed by wound dehiscence with low rates of other complications in surgical resection of LMs. Few patients required postoperative procedural intervention. Despite a relatively high rate of short-term complications, patients reported high satisfaction and symptom improvement following LM resection, which underscores the important role for surgical management of LMs in select patients.

Level of evidence

III.

Type of study

Cohort study.

目的：评价在单一多学科血管异常中心手术切除淋巴畸形（LMs）的疗效和术后并发症。方法：单中心回顾性分析2004年至2024年在第四转诊中心多学科血管异常小组接受淋巴畸形手术切除的所有≤21岁的患者。有关术后结果和治疗的数据被抽象化。结果：共纳入109例外科手术。术后30天最常见的并发症包括：血肿（18.3%）、手术部位浅表感染（18.3%）和伤口裂开（12.8%），神经麻痹/损伤（5.5%）、淋巴水肿（2.8%）、血肿（3.7%）和脓肿（4.6%）发生率较低。8例（7.3%）患者需要在术后30天内进行介入放射治疗，7例（6.4%）患者需要再次手术。在尝试完全切除的患者中，LM复发率为32.0%（16/50）。主观生活质量改善的占69.7%。术前接受硬化治疗的患者与未接受硬化治疗的患者术后并发症发生率无差异（p = 0.980）。结论：LMs术后短期并发症以血肿和手术部位感染最多，其次为伤口裂开，其他并发症发生率较低。很少患者需要术后手术干预。尽管短期并发症的发生率相对较高，但患者在LM切除术后报告了很高的满意度和症状改善，这强调了在特定患者中LM手术治疗的重要作用。证据水平：III。研究类型：队列研究。

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引用次数: 0

The Canadian Experience With Magnetic Esophageal Anastomosis: A Report From the Canadian Consortium for Research in Pediatric Surgery Study (CanCORPS). 加拿大食管磁吻合的经验：来自加拿大儿科外科研究联盟（CanCORPS）的报告。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-02 DOI: 10.1016/j.jpedsurg.2024.162150

Amanda Hall, Sherif Emil, Melanie Elhafid, Elena Guadagno, Cesar Kattini, Richard Keijzer, Sarah Klapman, Jean-Martin Laberge, Michael Livingston, Pramod Puligandla, Ahmed Nasr, Phillip Snarr, Fouad Youssef, Augusto Zani

Objective: Magnetic anastomosis is an innovative technique for establishing esophageal continuity in infants born with esophageal atresia. Few case series featuring this technology have been published, with even fewer reports on complications. We present the entire Canadian experience with this approach.

Methods: A nationwide retrospective review of all esophageal atresia patients treated with magnetic anastomoses in Canada was conducted through the Canadian Consortium for Research in Pediatric Surgery (CanCORPS).

Results: Magnetic anastomoses were attempted in nine patients including four Type A, two Type B, and three Type C. The median pre-operative esophageal gap was 2.9 cm (range 0.0-5.5 cm). In four patients, magnetic anastomosis was used as a salvage technique, after failed attempted primary repair. Seven patients (78 %) achieved esophageal patency after magnet insertion. Strictures developed in all successful cases and required a median of 10 dilatations (range 3-16). In one patient with a failed anastomosis, the proximal magnet perforated the proximal esophageal pouch, while in the second case, the magnets failed to couple together. One patient had an anastomosis form but required operative intervention shortly afterwards to both revise the anastomosis and address a missed proximal fistula.

Conclusion: In the Canadian experience, magnetic anastomosis was successful in establishing esophageal continuity in most patients. However, all patients developed strictures requiring multiple dilatations, and there was a substantial risk of complications requiring additional operative procedures. Further refinement of this technique may establish magnetic anastomosis as another tool for the pediatric surgeon treating long-gap and other challenging cases of esophageal atresia.

目的：磁吻合术是一种为食管闭锁患儿建立食管连续性的创新技术。很少有以该技术为特色的病例系列被发表，关于并发症的报道更少。我们介绍了加拿大在这方面的全部经验。方法：通过加拿大儿科外科研究协会（canorps），对加拿大所有采用磁吻合术治疗的食管闭锁患者进行全国性的回顾性研究。结果：A型4例，B型2例，c型3例，共9例，术前食管间隙中位数为2.9 cm（范围0 ~ 5.5 cm）。在4例患者中，在尝试初次修复失败后，使用磁吻合术作为挽救技术。7例患者（78%）在置入磁铁后食管通畅。所有成功病例均出现狭窄，需要进行中位数10次扩张（范围3-16）。在一例吻合失败的患者中，近端磁铁穿孔了近端食管袋，而在第二例中，磁铁未能结合在一起。1例患者有吻合形式，但不久后需要手术干预，以修改吻合方式并解决遗漏的近端瘘。结论：在加拿大的经验中，磁性吻合法在大多数患者中成功地建立了食管连续性。然而，所有患者都出现了需要多次扩张的狭窄，并且有很大的并发症风险，需要额外的手术治疗。该技术的进一步完善可能使磁吻合成为儿科外科医生治疗长间隙和其他具有挑战性的食管闭锁病例的另一种工具。

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引用次数: 0

Children With CDH are at High Risk for Pectus Excavatum Deformity and Progressive Thoracic Asymmetry 患有CDH的儿童患漏斗胸畸形和进行性胸部不对称的风险很高：CDH幸存者的胸壁畸形。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.162057

Carolin Riemer , Luisa Gräfin Lambsdorff , Nina Hutflesz , Christoph Mohr , Meike Weis , Christel Weiss , Richard Martel , Michaela Klinke Petrowsky , Katrin Zahn , Thomas Schaible , Michael Boettcher , Julia Elrod

Background

Congenital diaphragmatic hernia (CDH) survivors exhibit an increased risk for developing musculoskeletal anomalies. This prospective long-term cohort study investigates the characteristics, predictors and dynamic changes of different chest wall deformities in a large cohort of CDH patients.

Methods

All children diagnosed with CDH and treated at the University Hospital Mannheim from 2010 to 2023 were included. Thoracic morphology was evaluated based on 740 CT or MRI scans and statistical analysis was performed using the Mann-Whitney-U-Test, Fisher's Exact Test and Spearman's correlation. P-values<0.05 were considered statistically significant.

Results

Out of 1216 children with CDH, 548 received cross-sectional imaging examinations of the chest within the follow-up program. Mean Haller Index was 2.62 ± 0.55 and pectus excavatum deformity was present in 34.09 % of CDH patients. Thoracic asymmetry in favor of the right hemithorax was present in 45.90 % and showed a pronounced age-related progression. The severity of chest wall deformities showed a significant correlation with prenatal diagnosis, liver herniation, lower lung to head ratio and fetal relative lung volume, use of ECMO and inhaled nitric oxide, diaphragmatic patch closure and laparotomy.

Conclusion

Children with CDH show an increased incidence of chest wall deformities, including pectus deformity and asymmetry with the potential for significant age-related progression. Measurement of thoracic morphology using standardized parameters based on MRI or CT scans should be implemented as an essential component of standardized follow-up programs. Rigorous randomized, controlled intervention trials are required to evaluate whether certain therapies can alter the trajectory of these chest wall deformities.

背景：先天性膈疝（CDH）幸存者发生肌肉骨骼异常的风险增加。本前瞻性长期队列研究探讨了大量CDH患者不同胸壁畸形的特征、预测因素和动态变化。方法：纳入2010年至2023年在曼海姆大学医院诊断为CDH并接受治疗的所有儿童。根据740次CT或MRI扫描评估胸部形态，并使用mann - whitney - u检验、Fisher精确检验和Spearman相关进行统计分析。p值结果：在1216例CDH患儿中，548例在随访期间接受了胸部横断面成像检查。平均Haller指数为2.62±0.55,34.09%的CDH患者存在漏斗胸畸形。45.90%的胸腔不对称倾向于右半胸，并表现出明显的年龄相关进展。胸壁畸形严重程度与产前诊断、肝疝、低肺头比和胎儿相对肺体积、ECMO和吸入一氧化氮、膈补片闭合和剖腹手术有显著相关。结论：CDH患儿胸壁畸形发生率增加，包括胸侧畸形和不对称，并有可能出现明显的年龄相关进展。使用基于MRI或CT扫描的标准化参数测量胸部形态应作为标准化随访计划的重要组成部分。需要严格的随机对照干预试验来评估某些疗法是否能改变这些胸壁畸形的发展轨迹。

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引用次数: 0

Letter to the Editor in Response to: Reproductive Function and Fertility Preservation in Female Children, Girls, and Adolescents After Appendicular Pelvic Peritonitis: What About Abscesses? 致编辑的信阑尾盆腔腹膜炎后女性儿童、女孩和青少年的生殖功能和生育能力保护：脓肿怎么办？

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.161698

Giovanni Rollo, Giorgia Romano, Ottavio Domenico Adorisio, Lorna Spagnol, Massimiliano Silveri

引用次数: 0

Racial and Ethnic Survival Disparities in Pediatric Oncology Over Time: An Analysis of the SEER Registry 儿科肿瘤学中种族和民族生存率的长期差异：对 SEER 注册表的分析》（Pediatric Oncology in Racial and Ethnic Survival Disparities Over Time: An Analysis of SEER Registry）。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.161953

Nicole J. Kus , Shalini Sahoo , Theodore W. Laetsch , Gregory M. Tiao , Minerva Mayorga-Carlin , Yelena Yesha , John D. Sorkin , Brajesh K. Lal , Brian R. Englum

Background/Purpose

Studies have demonstrated existing racial and ethnic disparities in multiple aspects of pediatric oncology. The purpose of this study was to examine how racial and ethnic disparities in mortality among pediatric oncology patients have changed over time. We examined mortality by race and ethnicity over time within the Surveillance, Epidemiology, and End Results (SEER) registry.

Methods

Patients <20 years-old from 1975 to 2016 (n = 49,861) were selected for the analysis. Demographic characteristics, cancer diagnosis, and mortality data were extracted. Patients were divided by race and ethnicity: 1) non-Latino White, 2) Black, 3) Latino, and 4) Other Race. The interaction between race/ethnicity and decade was evaluated to better understand how disparities in mortality have changed over time.

Results

Unadjusted mortality among all cancers improved significantly, with 5-year mortality decreasing from the 1970s to the 2010s (log-rank: p < 0.001) for all race/ethnicity groups. However, improvements in mortality were not equal, with 5-year overall survival (OS) improving from 62.7 % in the 1970s to 87.5 % (Δ = 24.8 %) in the 2010s for White patients but only improving from 59.9 % to 80.8 % (Δ = 20.9 %) for Black patients (p < 0.01). The interaction between Race/Ethnicity and decade demonstrated that the Hazard Ratio (HR) for mortality worsened for Black [HR (95 % Confidence Interval): 1.10 (1.05–1.15) and Latino [1.11 (1.07–1.17)] patients compared to White, non-Latino patients.

Conclusion

There has been a dramatic improvement in survival across pediatric oncology patients since 1975. However, the improvement has not been shared equally across racial/ethnic categories, with overall survival worsening over time for racial/ethnic minorities compared to White patients.

Level of Evidence

III.

背景/目的：研究表明，在儿科肿瘤学的多个方面存在种族和民族差异。本研究旨在探讨儿科肿瘤患者死亡率中的种族和民族差异是如何随着时间的推移而变化的。我们在监测、流行病学和最终结果（SEER）登记系统中对不同种族和民族的死亡率进行了研究：患者结果：所有癌症的未调整死亡率均有显著改善，从 20 世纪 70 年代到 2010 年代，5 年死亡率一直在下降（对数秩：P 结论：从 20 世纪 70 年代到 2010 年代，所有癌症的未调整死亡率均有显著改善，从 20 世纪 70 年代到 2010 年代，5 年死亡率一直在下降：自 1975 年以来，儿科肿瘤患者的生存率有了大幅提高。然而，不同种族/族裔患者的生存率并没有得到平等的提高，与白人患者相比，少数种族/族裔患者的总体生存率随着时间的推移而下降：证据等级：III。

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引用次数: 0

Identifying Novel Genetic Markers in Pediatric Rhabdomyosarcoma 确定小儿横纹肌肉瘤的新型遗传标记物

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.161928

Joyce Xu , Theodore Wang , Sathyaprasad Burjonrappa

Background/Purpose

Rhabdomyosarcoma risk stratification is traditionally determined by tumor histology and staging. Recent studies revealed the importance of molecular features in predicting prognosis. We investigated prognosis by age of onset and mutation incidence in rhabdomyosarcoma tumors.

Methods

We retrospectively extracted clinical and genomic data from the Clinomics dataset (n = 641). Inclusion criteria was tumors with at least one gene mutation with >5% mutation incidence. Exclusion criteria were unknown risk stratification and age of onset. Statistical analysis was performed using ANOVA (p < 0.05) and Tukey's HSD to compare mutation incidence, EFS, and OS among age groups.

Results

Among 641 patients with rhabdomyosarcoma, 8 of 39 screened genes had >5% mutation incidence: NRAS, BCOR, NF1, TP53, FGFR4, KRAS, HRAS, and CTNNB1. The final cohort consisted of 370 patients: 51 (Age: 0–2 Years), 140 (Age: 2–5 Years), 112 (Age: 5–12 Years) and 67 (Age: 12+). Later age of onset is associated with higher incidence of BCOR and HRAS mutations (p < 0.005, p < 0.001) and poorer EFS and OS (p < 0.05, p < 0.001). In patients with BCOR mutations, later age of onset is associated with poorer EFS and OS (p < 0.005, p < 0.001). NF1 mutations are equally distributed among age groups (p = 0.82), but later age of onset is associated with poorer EFS and OS (p < 0.005, p < 0.001).

Conclusion

In patients with at least one mutation in BCOR, NF1, TP53, KRAS, HRAS, or CTNNB1, later age of onset is associated with poorer prognosis. In patients with mutations only in tumor suppressor genes BCOR or NF1, later age of onset is associated with poorer prognosis.

Type of Study

Retrospective Cohort Study.

Level of Evidence

II.

背景/目的：横纹肌肉瘤的风险分层传统上由肿瘤组织学和分期决定。最近的研究揭示了分子特征在预测预后方面的重要性。我们根据横纹肌肉瘤肿瘤的发病年龄和突变发生率对预后进行了研究：我们从临床组学数据集中回顾性地提取了临床和基因组数据（n = 641）。纳入标准是肿瘤至少有一个基因突变，且突变发生率>5%。排除标准为风险分层和发病年龄未知。统计分析采用方差分析（P 结果）：在 641 名横纹肌肉瘤患者中，39 个筛查基因中有 8 个基因的突变发生率大于 5%：NRAS、BCOR、NF1、TP53、FGFR4、KRAS、HRAS 和 CTNNB1。最终队列由 370 名患者组成：51例（年龄：0-2岁）、140例（年龄：2-5岁）、112例（年龄：5-12岁）和67例（年龄：12岁以上）。较晚的发病年龄与较高的 BCOR 和 HRAS 基因突变发生率有关（P 结论）：在 BCOR、NF1、TP53、KRAS、HRAS 或 CTNNB1 中至少有一种突变的患者中，较晚的发病年龄与较差的预后有关。在仅有肿瘤抑制基因 BCOR 或 NF1 发生突变的患者中，较晚的发病年龄与较差的预后有关：研究类型：回顾性队列研究：II.

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引用次数: 0

The Leader's Role in Hospital Surgeon Wellbeing: Organizational Wellness and Peer Support for APSA 领导者在医院外科医生福祉中的作用：为 APSA 提供组织健康和同伴支持。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.161977

Terry Buchmiller, Kurt Heiss, Loren Berman

引用次数: 0

We Must Say Good-bye to Dr. Mikko Pakarinen, but Please Say Hello to Drs. Augusto Zani and Robert Baird as Our Newest Executive Editors 我们必须向 Mikko Pakarinen 博士道别，但请向我们最新的执行编辑 Augusto Zani 博士和 Robert Baird 博士问好。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.162061

George W. Holcomb III

引用次数: 0

Decisions in Diversion: Enterostomy vs. Primary Anastomosis for Colonic Atresia 转流的决定：结肠闭锁的肠造口术与原位吻合术。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.161903

Utsav Patwardhan , Dylan Griffiths , Gerald Gollin

Background

Colonic atresia (CA) is associated with Hirschsprung disease (HD) in up to 10% of cases. Therefore, some surgeons elect to complete proximal diversion at the initial operation. We sought to better define the incidence of concurrent HD and evaluate practice patterns regarding diversion for CA.

Methods

The Pediatric Health Information System (PHIS) database was used to identify patients with CA from 2013 to 2022. Patients with small bowel atresia, anorectal malformation, gastroschisis, or first operation after 14 days of age were excluded. Index and subsequent operations were defined. Complications, time to enterostomy closure, and unplanned operations were evaluated.

Results

HD was diagnosed in 8 (9.5%) patients and 7 of these were initially diverted. Diverted and anastomosed patients were demographically similar. In the 58 (69%) patients initially diverted, 19 (33%) had an ileostomy. Continuity was restored with an ileo-colic anastomosis in 63% of diverted and 27% of primarily anastomosed patients. Of those initially managed with a colostomy, 53% ultimately had a colo-colonic anastomosis. Patients with primary anastomoses had fewer operations and received more days of parenteral nutrition. Other outcomes did not vary.

Conclusion

In a large population of infants with CA, 9.5% had concurrent HD. Almost 70% of CA patients underwent initial diversion and only one with HD had a primary anastomosis. Patients managed with a primary anastomosis were substantially more likely to retain the proximal colonic segment, but had a similar incidence of complications. When intraoperative colonic biopsies are obtained, primary anastomosis is a safe and effective strategy for CA.

Level of Evidence

3.

背景：结肠闭锁（CA）与赫氏prung 病（HD）相关的病例高达 10%。因此，一些外科医生选择在初次手术时完成近端转流。我们试图更好地界定并发 HD 的发生率，并评估 CA 引流的实践模式：我们使用儿科健康信息系统（PHIS）数据库来识别2013年至2022年的CA患者。排除了小肠闭锁、肛门直肠畸形、胃裂或14天后首次手术的患者。定义了首次手术和后续手术。对并发症、肠造口关闭时间和计划外手术进行了评估：结果：8 例（9.5%）患者被诊断为 HD，其中 7 例最初进行了肠道转流。转流患者和吻合患者的人口统计学特征相似。在 58 名（69%）最初进行转流的患者中，19 名（33%）进行了回肠造口术。63%的转流患者和 27% 的主要吻合患者通过回肠结肠吻合术恢复了连续性。在最初接受结肠造口术的患者中，53%最终进行了结肠-结肠吻合术。主要吻合的患者手术次数较少，接受肠外营养的天数较多。其他结果没有差异：结论：在大量 CA 婴儿中，9.5% 同时患有 HD。近 70% 的 CA 患者接受了初次转流，只有一名 HD 患者进行了初次吻合。接受初次吻合术的患者保留近端结肠段的几率要高得多，但并发症的发生率相似。如果在术中进行结肠活检，初次吻合术是一种安全有效的 CA 治疗策略：3:

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引用次数: 0

Sensory Recovery Following Intercostal Nerve Cryoablation for the Nuss Procedure 努斯手术肋间神经冷冻消融术后的感觉恢复。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.jpedsurg.2024.161904

John W. DiFiore , Jason O. Robertson , Wai Sung

Background

Intercostal nerve cryoablation (CRYO) during the Nuss procedure is effective for postoperative pain control, but little is known about patterns of sensory recovery following its use.

Methods

A single institution, prospective study of 121 patients undergoing Nuss bar placement with CRYO for pectus excavatum was conducted to assess sensory recovery. Patients received CRYO from T3-T8 and were followed at scheduled intervals. The primary outcome was time to return of normal chest wall sensation. Secondary outcomes included alterations in sensation, permanent numbness, and chronic neuropathic pain.

Results

Following CRYO, median time to normal sensation was 6.0 (range 1–12) months. This was achieved postoperatively by 14.9% at 3 months, 62.3% at 6 months, 85.1% at 9 months, and 98.3% at 12 months. 1.7% had a small area of persistent/permanent numbness in the lower central sternum. The most common altered sensation was hypersensitivity which occurred in 20.7%. Hypersensitivity began on average at 3.0 months postoperatively (range 0.25–6 months) and lasted a median of 1.0 (range 0.5–9) months. Only 5.8% described their altered sensation as painful, and all of these were successfully treated with gabapentin and/or capsaicin cream. All others resolved spontaneously. There were no cases of chronic neuropathic pain.

Conclusions

Sensory recovery following CRYO is a slow process that ultimately leads to normal sensation in virtually all patients by one year. Hypersensitivity is more common than expected but is rarely described as painful and always resolves. Permanent numbness can occur but is very rare and limited in scope.

Level of evidence

Therapeutic. Level IV.

背景：努斯手术中的肋间神经冷冻消融术（CRYO）可有效控制术后疼痛，但对其术后的感觉恢复模式却知之甚少：努斯手术中的肋间神经低温消融术（CRYO）可有效控制术后疼痛，但人们对其使用后的感觉恢复模式知之甚少：方法：对121名接受Nuss手术并使用CRYO的患者进行了单机构前瞻性研究，以评估患者的感觉恢复情况。患者在 T3 至 T8 期间接受 CRYO 治疗，并按计划时间间隔接受随访。主要结果是胸壁感觉恢复正常的时间。次要结果包括感觉改变、永久性麻木和慢性神经性疼痛：CRYO 术后，恢复正常感觉的中位时间为 6.0 个月（1-12 个月）。术后 3 个月达到正常感觉的比例为 14.9%，6 个月为 62.3%，9 个月为 85.1%，12 个月为 98.3%。1.7%的患者在胸骨中下部有一小块区域持续/永久麻木。最常见的感觉改变是过敏，发生率为20.7%。超敏反应平均在术后 3.0 个月开始（范围为 0.25-6 个月），持续时间中位数为 1.0 个月（范围为 0.5-9 个月）。只有 5.8% 的患者将其改变的感觉描述为疼痛，所有这些患者都成功接受了加巴喷丁和/或辣椒素软膏的治疗。其他病例均自行缓解。没有出现慢性神经病理性疼痛的病例：结论：CRYO 治疗后的感觉恢复是一个缓慢的过程，最终几乎所有患者都能在一年内恢复正常感觉。超敏反应比预期的更为常见，但很少有疼痛的描述，而且总是可以缓解。可能会出现永久性麻木，但非常罕见且范围有限：证据等级：治疗：

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引用次数: 0