Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Cleft Palate Craniofac J. 2023 Jul;60(7):804-809. doi: 10.1177/10556656221085478. Epub 2022 Mar 7.
This multicenter study aimed to compare demographic, operative, and short-term outcomes data between open and minimally invasive surgical approaches for craniosynostosis repair utilizing the American College of Surgeon's National Surgical Quality Improvement Program Pediatric (NSQIP-P) database and highlight surgical disparities among races and ethnicities.
Retrospective review of large multicenter database.
Freestanding general acute care children's hospitals, children's hospitals within a larger hospital, specialty children's hospitals, or general acute care hospitals with a pediatric wing.
A total of 4931 pediatric patients underwent craniosynostosis correction within the NSQIP-P database from 2013 to 2019.
None.
MAIN OUTCOME MEASURE(S): Demographic information included age at surgery, sex, race, and ethnicity. Operative and outcomes measures included operative time, anesthesia time, days until discharge, postoperative complications, blood transfusions, 30-day readmission, and 30-day unplanned return to operating room.
Patients who underwent minimally invasive surgery had significantly shorter operative and anesthesia times ( < .001; < .001), fewer days until discharge ( < .001), fewer postoperative complications ( < .05), and less blood transfusions ( < .001). The proportion of White patients was significantly higher in the minimally invasive surgery group ( < .01), whereas Black and Hispanic patients had a significantly higher proportion in the open surgery group ( < .001; < .001). Additionally, the percentage of patients undergoing minimally invasive surgery increased from 3.8% in 2014 to over 13% in 2019.
This study adds to a growing consensus that minimally invasive surgery has significantly decreased operative time, anesthesia time, transfusion rates, length of hospital stay, and postoperative complications compared to open surgery. Racial and ethnic surgical disparities showed larger proportions of Black and Hispanic populations undergoing open procedures.
本多中心研究旨在比较美国外科医师学院国家手术质量改进计划儿科（NSQIP-P）数据库中经颅缝早闭修复的开放手术和微创手术的人口统计学、手术和短期结果数据，并强调不同种族和族裔之间的手术差异。
回顾性分析大型多中心数据库。
独立的普通急症儿童医院、大型医院内的儿童医院、专科医院或设有儿科病房的普通急症医院。
共有 4931 名儿科患者在 2013 年至 2019 年期间在 NSQIP-P 数据库中接受了颅缝早闭矫正。
无。
人口统计学信息包括手术时的年龄、性别、种族和族裔。手术和结果测量包括手术时间、麻醉时间、出院天数、术后并发症、输血、30 天再入院和 30 天非计划重返手术室。
接受微创手术的患者手术和麻醉时间明显缩短（ < .001； < .001），出院天数减少（ < .001），术后并发症减少（ < .05），输血减少（ < .001）。微创手术组的白人患者比例明显更高（ < .01），而开放手术组的黑人和西班牙裔患者比例明显更高（ < .001； < .001）。此外，微创手术的比例从 2014 年的 3.8%增加到 2019 年的 13%以上。
这项研究增加了越来越多的共识，即与开放手术相比，微创手术在减少手术时间、麻醉时间、输血率、住院时间和术后并发症方面具有显著优势。种族和族裔手术差异表明，接受开放手术的黑人和西班牙裔人群比例更大。
