Ophthalmology department, University hospital of Nice, Cote d'Azur University, Nice, France.
Ophthalmic Epidemiol. 2021 Dec;28(6):526-532. doi: 10.1080/09286586.2021.1880605. Epub 2021 Feb 12.
To assess the annual incidence, surgical technique preferred (i.e. external versus endonasal) and the characteristics of patients undergoing a Dacryocystorhinostomy (DCR) in France over a 10-year-period.
A national observational cohort study was conducted in France between January 2010 and December 2019. Data were collected from the national PMSI (Programme de Médicalisation des Sytèmes d'Information) database provided by the CNAM (Caisse Nationale de l'Assurance Maladie). All patients undergoing a DCR were included.
Twenty-one thousand one hundred ninety-nine patients, with a mean age of 70.4 years, were included. A female predominance (78%) was noted. The mean annual number of DCRs was 2481 (2366-2633), corresponding to a mean incidence of 3.8 per 100,000 person-years. This number remained stable over the study period ( = .966). Of the 24,808 DCRs, external DCRs were more prevalent compared to endonasal procedures (70.8% vs. 29.2%, = .0001). Six hundred and fifteen (2.5%) associated acts were performed intraoperatively, mainly during endonasal DCR (96.3%). A total of 10,857 (43.8%) silicone stents were placed intraoperatively. Bicanalicular silicone stenting was preferred over the monocanalicular stenting. All the regions performed more likely external DCR except the Île-de-France area where endonasal DCR was performed in 75.6% of procedures. DCRs were mainly performed by an ophthalmologist (80%).
The mean annual incidence of external and endonasal DCRs remained stable over the study period. Endonasal DCR was more likely performed by the otorhinolaryngologists, emphasizing the need to develop personalized endonasal training in the ophthalmology residency program.
评估法国在 10 年内行泪囊鼻腔吻合术（DCR）的年度发病率、首选手术技术（即经鼻内镜与经外路）以及患者特征。
本项在法国进行的全国性观察性队列研究于 2010 年 1 月至 2019 年 12 月间开展。数据来自国家 PMSI（Programme de Médicalisation des Sytèmes d'Information）数据库，由国家健康保险基金（Caisse Nationale de l'Assurance Maladie）提供。所有行 DCR 的患者均纳入研究。
共纳入 21199 例患者，平均年龄为 70.4 岁，女性患者居多（78%）。年 DCR 例数平均为 2481 例（2366-2633 例），相应的发病率为 3.8/10 万人年。研究期间该数字保持稳定（ =.966）。在 24808 例 DCR 中，经外路 DCR 比经鼻内镜手术更为常见（70.8% vs. 29.2%， =.0001）。术中进行了 615 例（2.5%）辅助操作，主要在经鼻内镜 DCR 术中进行（96.3%）。术中共放置 10857 例（43.8%）硅胶支架，双腔硅胶支架较单腔支架更常用。除法兰西岛大区（该地区 75.6%的手术采用经鼻内镜）外，所有地区均更倾向于行经外路 DCR，经鼻内镜 DCR。行 DCR 的主要是眼科医生（80%）。
研究期间，经外路和经鼻内镜 DCR 的年平均发病率保持稳定。经鼻内镜 DCR 更可能由耳鼻喉科医生开展，这强调了在眼科住院医师培训项目中开展个体化经鼻内镜培训的必要性。
