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.
J Pediatr Surg. 2021 Dec;56(12):2258-2262. doi: 10.1016/j.jpedsurg.2021.01.034. Epub 2021 Jan 27.
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.
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.
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.
Costal cartilage resection is an effective treatment for SRS with high satisfaction rates and an appropriate consideration for patients who fail conservative management.
Level IV; Case series with no comparison groups.
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。
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。
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。
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。
四级；无对照的病例系列。
