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沙特阿拉伯小儿外科医生和小儿泌尿科医生在隐睾症治疗管理方面观点的比较。

Comparison of the perspectives of the pediatric surgeons and pediatric urologists in management of cryptorchidism in Saudi Arabia.

机构信息

From the Department of Surgery (Bawazir O), Faculty of Medicine, Umm Al-Qura University; from the Pediatric Surgery Department (Maghrabi), Maternity and Children Hospital, Makkah; and from the College of Medicine (Binyahib, Bawazir R, Halabi, Bawazir A), King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2021 May;42(5):555-561. doi: 10.15537/smj.2021.42.5.20210007.

Abstract

OBJECTIVES

To evaluate the variability in perspectives between pediatric surgeons and pediatric urologists in managing cryptorchidism.

METHODS

We conducted this survey among pediatric surgeons and pediatric urologists managing cryptorchidism in Saudi Arabia in October 2020. We distributed a questionnaire to 187 consultants using the Google forms platform. We collected data related to the consultant's experience, preoperative management, management of nonpalpable testes, management of palpable undescended testes, management of the cryptorchidism in special situations.

RESULTS

The response rate was 77% for pediatric surgeons (n=77) and 46% for pediatric urologists (n=40). The number of cases managed by each specialty per year differed significantly (=0.02); however, there was no significant difference in their experience (=0.37). The preferred age for orchidopexy was 6-12 months for both specialties. Pediatric surgeons tend to prescribe preoperative ultrasound more frequently for nonpalpable testes (=0.05). Laparoscopy was the preferred surgical approach by both specialties. Management of intra-abdominal testes not reaching the contralateral internal ring differed between groups (<0.001), and it was related to the number of procedures performed annually (=0.03). Both groups responded differently to the management of unsatisfactory testicular position after orchidopexy (<0.001). Pediatric surgeons managed it with either observation or re-operative inguinal orchidopexy; however, most pediatric urologists preferred re-operative inguinal orchidopexy. This response was affected by the number of procedures performed annually (=0.04).

CONCLUSION

In Saudi Arabia, practicing pediatric surgeons and pediatric urologists have different perspectives in the management of cryptorchidism. The results of this survey demonstrated the need to establish national guidelines to manage patients with cryptorchidism.

摘要

目的

评估小儿外科医生和小儿泌尿科医生在处理隐睾症时观点的差异。

方法

我们于 2020 年 10 月在沙特阿拉伯管理隐睾症的小儿外科医生和小儿泌尿科医生中进行了这项调查。我们使用 Google 表单平台向 187 名顾问分发了问卷。我们收集了与顾问经验、术前管理、不可触及睾丸的管理、可触及未降睾丸的管理、特殊情况下隐睾症的管理相关的数据。

结果

小儿外科医生的回复率为 77%(n=77),小儿泌尿科医生的回复率为 46%(n=40)。每个专业每年管理的病例数量差异显著(=0.02);然而,他们的经验差异没有统计学意义(=0.37)。两种专业都倾向于 6-12 个月龄时进行睾丸固定术。小儿外科医生更倾向于为不可触及的睾丸开具术前超声检查(=0.05)。腹腔镜检查是两种专业都首选的手术方法。对于未到达对侧内环的腹腔内睾丸的处理方式,两组之间存在差异(<0.001),且与每年进行的手术次数有关(=0.03)。两组对睾丸固定术后睾丸位置不满意的处理方式反应不同(<0.001)。小儿外科医生采用观察或再次经腹股沟睾丸固定术处理;然而,大多数小儿泌尿科医生更倾向于再次经腹股沟睾丸固定术。这种反应受到每年进行的手术次数的影响(=0.04)。

结论

在沙特阿拉伯,从事小儿外科和小儿泌尿科的医生在隐睾症的管理方面观点存在差异。这项调查的结果表明,有必要制定国家指南来管理隐睾症患者。

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本文引用的文献

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7
Evaluation and treatment of cryptorchidism: AUA guideline.隐睾症的评估和治疗:AUA 指南。
J Urol. 2014 Aug;192(2):337-45. doi: 10.1016/j.juro.2014.05.005. Epub 2014 May 20.
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Orchidopexy patterns in Austria from 1993 to 2009.1993 年至 2009 年奥地利的隐睾固定术模式。
J Pediatr Urol. 2013 Oct;9(5):535-41. doi: 10.1016/j.jpurol.2012.08.003. Epub 2012 Sep 8.
10
Undescended testes in children: the paediatric urologist's point of view.儿童隐睾症:儿科泌尿科医生的观点。
Eur J Endocrinol. 2008 Dec;159 Suppl 1:S83-6. doi: 10.1530/EJE-08-0162. Epub 2008 Jul 15.

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