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利用日本视网膜脱离登记系统分析节假日与工作日进行的原发性视网膜脱离手术的差异。

Differences in primary retinal detachment surgery conducted on holidays and workdays analyzed using the Japan Retinal Detachment Registry.

作者信息

Kawano Sumihiro, Imai Takumi, Sakamoto Taiji

机构信息

Department of Ophthalmology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.

Japan-Retinal Detachment Registry Group, Osaka, Japan.

出版信息

Jpn J Ophthalmol. 2022 May;66(3):271-277. doi: 10.1007/s10384-022-00911-6. Epub 2022 Mar 20.

Abstract

PURPOSE

To investigate the characteristics of retinal detachment (RD) and compare the outcomes of surgical interventions, such as scleral buckling (SB), pars plana vitrectomy (PPV), or PPV combined with SB, conducted on holidays and on workdays to determine the optimal surgical timing for primary RD treatment in clinical practice.

STUDY DESIGN

Retrospective cohort study.

METHODS

The cohort included 3178 patients with primary RD registered in the Japan Retinal Detachment Registry between February 2016 and March 2017. Surgery data were divided into holiday and workday groups. A descriptive analysis of primary RD characteristics was performed, and the outcomes for each surgical intervention were assessed. The primary outcome was anatomical failure at 6 months post-surgery classified as follows: level 1, inoperable state; level 2, anatomical recovery with silicone-oil use; and level 3, additional surgery required for RD repair.

RESULTS

The holiday group comprised 108 and the workday, 3070 cases of primary RD. Compared with those in the workday group, surgery in the holiday group took longer (PPV, P < 0.0001; SB, P = 0.047) and was performed by less experienced surgeons (P = 0.014). However, there were no statistically significant differences in surgical failure 6 months post-surgery between the workday and holiday groups.

CONCLUSION

Although surgery conducted on holidays and workdays was not significantly different in terms of outcome, some surgery should be postponed with proper preoperative interim measures to limit RD progress until it can be conducted on workdays by a well-prepared team.

摘要

目的

研究视网膜脱离(RD)的特征,并比较在节假日和工作日进行的巩膜扣带术(SB)、玻璃体切除术(PPV)或PPV联合SB等手术干预的效果,以确定临床实践中原发性RD治疗的最佳手术时机。

研究设计

回顾性队列研究。

方法

该队列包括2016年2月至2017年3月在日本视网膜脱离登记处登记的3178例原发性RD患者。手术数据分为节假日组和工作日组。对原发性RD特征进行描述性分析,并评估每种手术干预的效果。主要结局为术后6个月的解剖学失败,分类如下:1级,无法手术状态;2级,使用硅油后解剖学恢复;3级,RD修复需要额外手术。

结果

节假日组有108例原发性RD,工作日组有3070例。与工作日组相比,节假日组的手术时间更长(PPV,P<0.0001;SB,P=0.047),且由经验较少的外科医生进行手术(P=0.014)。然而,工作日组和节假日组术后6个月的手术失败率在统计学上没有显著差异。

结论

虽然节假日和工作日进行的手术在结果方面没有显著差异,但一些手术应采取适当的术前临时措施推迟进行,以限制RD进展,直到可以由准备充分的团队在工作日进行手术。

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