Department of Urology, Division of Pediatric Urology, University of California, San Francisco, CA, USA.
Department of Urology, Division of Pediatric Urology, University of California, San Francisco, CA, USA.
J Pediatr Urol. 2018 Apr;14(2):175.e1-175.e6. doi: 10.1016/j.jpurol.2017.11.018. Epub 2018 Jan 9.
Patients undergo pediatric urologic surgery as infants and young children.
The purpose of the study was to evaluate the evolution of surgical scars over several years in order to inform parents and surgeons on the true cosmetic impact of pediatric surgery and evaluate patient scar satisfaction.
This was a cross-sectional study where patients who have undergone urologic surgery at a young age are evaluated years later for scar satisfaction via an abbreviated validated questionnaire. Scar length currently was measured and compared with immediate postoperative scar length to assess for growth.
Eighty-two children were evaluated with a median age (interquartile range) at the time of surgery and at the time of the study of 1 year (0.6-3 years) and 7 years (3-11 years), respectively. Pyeloplasty (48.8%), ureteral reimplantation/ureterocele reconstruction (41.5%) and other (9.8%) surgical techniques were included. No bother was reported in 84.0% of families. Surgical approach (robotic/laparoscopic vs. open) did not influence whether families reported very pleased/pleased versus neutral/somewhat bothered attitudes (p = 0.094). At time of surgery median scar length for all open surgical approaches (N = 65) was 4 cm (IQR 4-4.5 cm) and at time of the study scars were 6 cm (IQR 5-8 cm). For laparoscopic incisions, median length at time of surgery was 0.8 cm (IQR 0.8-1.1 cm) and at a mean follow up time of 2.3 years median scar length was 1.1 cm (IQR 1-1.5 cm). By race, Asian experienced the lowest percent change in scar length 0.3%, then Caucasian 0.8%, Latino 1.4% and self-described other ethnicity 2.0%.
As predicted, scars grow in length over time in either open or minimally surgical approaches. Depending on patient race, scar growth varied. Regardless, survey results did not vary based on surgical approach, type of surgery or race of survey taker Summary figure.
The majority of families are pleased with overall scar appearance after undergoing major pediatric urologic surgery. Scars tend to grow in length overtime with less growth noted in Asian children and flank incisions.
患者在婴儿和幼儿时期接受小儿泌尿科手术。
本研究的目的是评估手术疤痕在数年中的演变，以便向家长和外科医生告知小儿手术的真实美容影响，并评估患者对疤痕的满意度。
这是一项横断面研究，对早年接受过泌尿科手术的患者进行评估，数年后通过简短的经过验证的问卷评估他们对疤痕的满意度。目前测量疤痕长度，并与术后即刻的疤痕长度进行比较，以评估生长情况。
82 名儿童接受了评估，手术时的中位年龄（四分位距）为 1 岁（0.6-3 岁），研究时的中位年龄为 7 岁（3-11 岁）。纳入的手术技术包括肾盂成形术（48.8%）、输尿管再植/输尿管囊肿重建（41.5%）和其他（9.8%）。84.0%的家庭报告无困扰。手术方法（机器人/腹腔镜与开放）并不影响家庭报告非常满意/满意与中性/有些困扰的态度（p=0.094）。所有开放手术入路（N=65）手术时的中位疤痕长度为 4cm（四分位距 4-4.5cm），研究时的疤痕长度为 6cm（四分位距 5-8cm）。腹腔镜切口的中位长度在手术时为 0.8cm（四分位距 0.8-1.1cm），在平均随访 2.3 年后的中位疤痕长度为 1.1cm（四分位距 1-1.5cm）。按种族划分，亚洲人种的疤痕长度变化最小，为 0.3%，其次是白种人 0.8%、拉丁裔 1.4%和自我描述的其他种族 2.0%。
正如预期的那样，无论是开放手术还是微创手术，疤痕的长度都会随着时间的推移而增长。根据患者的种族不同，疤痕的生长情况也不同。无论如何，调查结果都与手术入路、手术类型或调查者的种族无关。
大多数家庭对接受小儿泌尿科重大手术后的整体疤痕外观感到满意。随着时间的推移，疤痕的长度往往会增长，而亚洲儿童和侧腹部切口的疤痕增长较少。
