Tutku Soyer, Luca Pio, Ramon Gorter, Leopoldo Martinez, Jens Dingemann, Federica Pederiva, Anne Dariel, Elke Zani-Ruttenstock, Mohit Kakar, Nigel J. Hall
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The majority of respondents cited the risk of incarceration as the reason for advocating surgery prior to discharge, whereas a reduced risk of apnea was the most cited reason for respondents who prefer delayed surgery. Open approach under general anesthesia was favored by 54% of respondents, with 27% of them preferring open approach with spinal anesthesia. Laparoscopic surgery for premature infants is used in 11% while 7% of them preferred in all premature infants including extremely/very premature ones. Contralateral side evaluation was never done by 40% of respondents and 29% only performed it only during laparoscopic repair. The majority of respondents (77%) indicated that they have an overnight stay policy for premature infants < 45 weeks of gestation.</p> <p>\n<b>Conclusion</b> There is variation in the practice patterns of pediatric surgeons in the treatment of IH in premature infants. 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引用次数: 0
摘要
目的 本文评估了欧洲儿科外科医生协会(EUPSA)会员在早产儿腹股沟疝(IH)修复时机方面的实践模式。方法 于 2023 年 1 月向欧盟儿科外科医生协会会员发放包含 29 个问题的在线调查问卷。结果 共收到 180 份回复。总体而言,有监禁史的受访者中有 60% 支持在出院前进行 IH 修复,没有监禁史的受访者中有 56% 支持在出院前进行 IH 修复。对于无嵌顿病史的极早产/极早产儿(< 32 周),将手术推迟到出院后进行的受访者较少(43%)。大多数受访者主张在出院前进行手术的原因是存在嵌顿风险,而喜欢延迟手术的受访者最常提到的原因是降低呼吸暂停的风险。54%的受访者倾向于全身麻醉下的开放式手术,27%的受访者倾向于脊髓麻醉下的开放式手术。11%的受访者对早产儿采用腹腔镜手术,7%的受访者对包括极早产/极早产儿在内的所有早产儿均采用腹腔镜手术。40%的受访者从未进行过对侧评估,29%的受访者仅在腹腔镜修复手术中进行过对侧评估。结论 儿科外科医生治疗早产儿 IH 的实践模式存在差异。由于担心发生嵌顿的高风险,在出院前进行 IH 修复是最普遍的做法。术后呼吸暂停风险较低是推迟手术的最常见原因。要确定早产儿 IH 修复的最佳时机,还需要进行随机研究。
European Pediatric Surgeons' Association Survey on Timing of Inguinal Hernia Repair in Premature Infants
Aim This article evaluates the practice patterns of European Pediatric Surgeons' Association (EUPSA) members regarding the timing of inguinal hernia (IH) repair in premature infants.
Methods Online survey containing 29 questions distributed to EUPSA members during January 2023.
Results A total of 180 responds were received. Overall, IH repair prior to discharge was favored by 60% of respondents when there was a history of incarceration and 56% when there was not. In the case of very/extremely premature infants (< 32 weeks) with no history of incarceration, fewer (43%) respondents postpone the surgery until after discharge. The majority of respondents cited the risk of incarceration as the reason for advocating surgery prior to discharge, whereas a reduced risk of apnea was the most cited reason for respondents who prefer delayed surgery. Open approach under general anesthesia was favored by 54% of respondents, with 27% of them preferring open approach with spinal anesthesia. Laparoscopic surgery for premature infants is used in 11% while 7% of them preferred in all premature infants including extremely/very premature ones. Contralateral side evaluation was never done by 40% of respondents and 29% only performed it only during laparoscopic repair. The majority of respondents (77%) indicated that they have an overnight stay policy for premature infants < 45 weeks of gestation.
Conclusion There is variation in the practice patterns of pediatric surgeons in the treatment of IH in premature infants. Due to the concern for the high risk of incarceration, IH repair before discharge was the most prevalent practice. Lower risk of postoperative apnea was cited as the most common reason for delaying surgery. Randomized studies are required to establish the optimal timing for IH repair in premature infants.
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