Heydweiller Andreas, Kurz Ralf, Schröder Arne, Oetzmann von Sochaczewski Christina
Sektion Kinderchirurgie, Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Klinik für Kinder- und Jugendmedizin, Klinikum Dortmund, Dortmund, Germany.
BMC Surg. 2021 Oct 20;21(1):372. doi: 10.1186/s12893-021-01371-4.
Contrary to adult inguinal hernia surgery, large-scale investigations using registries or administrative data are missing in paediatric surgery. We aimed to fill this gap by analysing German administrative hospital data to describe the current reality of inpatient hernia surgery in children.
We analysed aggregated data files bought from the German federals statistics office on hospital reimbursement data separately for principal diagnoses of inguinal hernia in children and for herniotomies in inpatients. Developments over time were assessed via regression and differences between groups with nonparametric comparisons.
Principal diagnoses of hernias were decreasing over time with the exception of male bilateral and female bilateral incarcerated hernias in the first year of life which increased. The vast majority of operations were conducted via the open approach and laparoscopy was increasingly only used for females older than 1 year of age. Recurrent hernia repair was scarce. Rates of inguinal hernia repair were higher in both sexes the younger the patient was, but were also decreasing in all age groups despite a population growth since 2012. The amount of inguinal hernia repairs by paediatric surgeons compared to adult surgeons increased by 1.5% per year.
Our results corroborate previous findings of age and sex distribution. It demonstrates that inpatient hernia repair is primarily open surgery with herniorrhaphy and that recurrences seem to be rare. We observed decreasing rates of hernia repairs over time and as this has been described before in England, future studies should try to elucidate this development.
III.
与成人腹股沟疝手术不同，儿科手术缺乏使用登记处或行政数据进行的大规模调查。我们旨在通过分析德国医院行政数据来填补这一空白，以描述儿童住院疝手术的当前现状。
我们分别分析了从德国联邦统计局购买的关于医院报销数据的汇总数据文件，这些数据涉及儿童腹股沟疝的主要诊断和住院患者的疝修补术。通过回归分析评估随时间的发展情况，并通过非参数比较评估组间差异。
除出生后第一年男性双侧和女性双侧嵌顿疝有所增加外，疝的主要诊断随时间呈下降趋势。绝大多数手术采用开放手术方式，腹腔镜检查越来越多地仅用于1岁以上的女性。复发性疝修补术很少见。患者年龄越小，腹股沟疝修补率在两性中越高，但自2012年以来尽管人口增长，所有年龄组的修补率也在下降。与成人外科医生相比，儿科外科医生进行的腹股沟疝修补量每年增加1.5%。
我们的结果证实了先前关于年龄和性别分布的研究结果。这表明住院疝修补主要是开放式疝修补手术，且复发似乎很少见。我们观察到疝修补率随时间下降，正如之前在英国所描述的那样，未来的研究应试图阐明这一发展情况。
III级
