Sector de Cirugía Uretral y Genital Reconstructiva, Servicio de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Sector de Cirugía Uretral y Genital Reconstructiva, Servicio de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Actas Urol Esp (Engl Ed). 2021 Oct;45(8):557-563. doi: 10.1016/j.acuroe.2021.07.004. Epub 2021 Sep 12.
To analyze the results and complications after urethroplasty based on patient age groups. As secondary objective, we analyzed the impact of operative complexity on each age group.
This is a retrospective cohort study that include male patients who underwent urethroplasty between January 2011 and December 2018. Data was obtained from the patients' electronic health records. Patients were grouped as follows: <60 years, 60-79 years and >80 years. Variables evaluated were history, comorbidities, previous surgeries and operative complexity. Restenosis-free survival and complications presented in each group were determined according to the Clavien-Dindo classification system. The SPSS® program was used for statistical analysis.
A total of 783 patients were included, and the mean follow-up was 19 months. The estimated 2-year restenosis-free survival in the population under 60, 60-79 and over 80 years was 87, 87 and 93.9% (IC 95%), respectively. Univariate analysis showed that the age group was not a predictor of restenosis. Complex surgery is the only predictor of recurrence, increasing the risk by 60% (HR 1.64, 95% CI 1.05-2.56, p = 0.029). There was an overall complication rate of 30.8%, and 62% of these were Clavien ≤ II. We found no association between the frequency of complications and age.
Urethroplasty is safe and effective regardless of age group. There are no statistically significant differences in outcomes and complications shown by the age group comparison. There were no significant differences when analyzing the impact of complex surgeries among the different age groups. The data indicate that age alone should not be taken as an absolute exclusion criterion for patients needing urethral reconstruction.
根据患者年龄组分析尿道成形术后的结果和并发症。作为次要目标，我们分析了手术复杂性对每个年龄组的影响。
这是一项回顾性队列研究，纳入了 2011 年 1 月至 2018 年 12 月期间接受尿道成形术的男性患者。数据来自患者的电子健康记录。患者分为以下三组：<60 岁、60-79 岁和>80 岁。评估的变量包括病史、合并症、既往手术和手术复杂性。根据 Clavien-Dindo 分类系统确定每组的无再狭窄生存率和并发症。使用 SPSS®程序进行统计分析。
共纳入 783 例患者，平均随访时间为 19 个月。<60、60-79 和>80 岁人群的 2 年无再狭窄生存率分别估计为 87%、87%和 93.9%（95%CI）。单因素分析表明，年龄组不是再狭窄的预测因素。复杂手术是再发的唯一预测因素，风险增加 60%（HR 1.64，95%CI 1.05-2.56，p=0.029）。总体并发症发生率为 30.8%，其中 62%为 Clavien≤Ⅱ级。我们没有发现并发症的频率与年龄之间存在关联。
尿道成形术无论年龄组如何，都是安全有效的。结果和并发症的年龄组比较没有统计学上的显著差异。在分析不同年龄组之间复杂手术的影响时，没有发现显著差异。数据表明，年龄本身不应作为需要尿道重建的患者的绝对排除标准。
