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肋骨滑动综合征肋软骨切除术后的长期结果和满意度。

Long-term outcomes and satisfaction rates after costal cartilage resection for slipping rib syndrome.

机构信息

Department of Pediatric Surgery, Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108, USA.

Department of Pediatric Surgery, Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108, USA.

出版信息

J Pediatr Surg. 2021 Dec;56(12):2258-2262. doi: 10.1016/j.jpedsurg.2021.01.034. Epub 2021 Jan 27.

Abstract

PURPOSE

Slipping rib syndrome (SRS) is a challenging and underdiagnosed condition. We previously demonstrated the efficacy of costal cartilage resection for SRS and now report long-term follow-up of our updated cohort.

METHODS

Retrospective chart review with prospective telephone follow-up was performed for 30 previously analyzed patients and 22 new patients to elucidate risk factors for recurrence, discuss preoperative experience, current symptoms, postoperative course, and satisfaction.

RESULTS

From 2006-2020, 49 patients met inclusion criteria and underwent 67 operations. Eleven underwent re-operation for recurrence, with median time of 1.6 years [1.2, 2.6]. Median age of symptom onset was 13 years [11,14] while median age at diagnosis was 15.4 years [14, 16.7]. 29/49 (59%) patients were contacted, with median follow-up of 4.5 years [2.1, 5.7]. Twenty-one patients (72%) reported complete cure, 20 (69%) reported satisfaction 10/10, with 83% rating their satisfaction >7/10. Eleven patients (38%) were offered opioids for pain control prior to surgical evaluation. Patients with recurrence had residual or fused cartilage, hypermobile bony ribs, or both, at re-excision.

CONCLUSIONS

Costal cartilage resection is an effective treatment for SRS with high satisfaction rates and an appropriate consideration for patients who fail conservative management.

LEVEL OF EVIDENCE

Level IV; Case series with no comparison groups.

摘要

目的

滑动肋综合征(SRS)是一种具有挑战性且诊断不足的病症。我们之前已经证明了肋软骨切除术治疗 SRS 的有效性,现在报告我们更新队列的长期随访结果。

方法

对之前分析的 30 名患者和 22 名新患者进行回顾性图表审查和前瞻性电话随访,以阐明复发的风险因素,讨论术前体验、当前症状、术后过程和满意度。

结果

2006 年至 2020 年,共有 49 名符合纳入标准的患者接受了 67 次手术。11 名患者因复发而再次手术,中位时间为 1.6 年[1.2,2.6]。症状发作的中位年龄为 13 岁[11,14],而诊断时的中位年龄为 15.4 岁[14,16.7]。49 名患者中有 29 名(59%)接受了联系,中位随访时间为 4.5 年[2.1,5.7]。21 名患者(72%)报告完全治愈,20 名患者(69%)报告 10/10 的满意度,83%的患者满意度评分>7/10。11 名患者(38%)在手术评估前因疼痛控制而接受阿片类药物治疗。在再次切除时,复发患者的肋软骨仍有残余或融合、骨肋骨活动过度或两者兼有。

结论

肋软骨切除术是 SRS 的有效治疗方法,满意度高,是对保守治疗失败的患者的适当考虑。

证据水平

四级;无对照的病例系列。

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