Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY, USA.
Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY, USA.
J Pediatr Surg. 2023 Dec;58(12):2405-2409. doi: 10.1016/j.jpedsurg.2023.07.016. Epub 2023 Aug 2.
In the pediatric population, vaginoplasties can be performed in patients with either congenital malformations or acquired conditions. To our knowledge, there has been no study to date investigating the outcomes of vaginoplasty in the pediatric population using a nationwide database. Here, we present a national cohort study of perioperative characteristics and 30-day complications of vaginoplasty in pediatric patients.
A level II retrospective, prognosis cohort study was performed using the Pediatric National Surgical Quality Improvement Program (NSQIP-P) database from 2012 to 2020. Data from patients age 0 to 18 who underwent vaginoplasty was queried using CPT code 57,335. Descriptive analysis was performed to elucidate patterns in patient demographics, perioperative characteristics, and 30-day postoperative outcomes.
A total of 183 patients were identified. Median age was 2.41 years (IQR 0.9 to 12.1). In this population, 58.5% of patients had ASA class 2, and 33.3% ASA class 3. Congenital malformation was present in 75.9%. Average total length of stay was 2.7 days (SD = 3.8) and readmission rate was 7.86%. Complications included urinary tract infection (3.3%), bleeding/transfusions (2.2%), organ/space surgical site infection (1.1%), and superficial incisional surgical site infection (0.6%). The most common procedures performed simultaneously with vaginoplasty included cystourethroscopy (n = 66), clitoroplasty for intersex state (n = 58), and plastic repair of introitus (n = 22).
Vaginoplasties in the pediatric population were found to have low rates of 30-day readmission and low incidence of 30-day postoperative complications. Further studies focusing on prospective clinical data related to pediatric vaginoplasty can help identify factors to improve long-term outcomes in this population.
在儿科人群中，阴道成形术可用于治疗先天性畸形或后天性疾病。据我们所知，目前尚无研究使用全国性数据库调查儿科人群阴道成形术的结果。在此，我们报告了一项全国性儿科患者阴道成形术围手术期特征和 30 天并发症的队列研究。
使用 2012 年至 2020 年的小儿国家手术质量改进计划（NSQIP-P）数据库进行了 II 级回顾性预后队列研究。使用 CPT 代码 57,335 查询年龄在 0 至 18 岁之间接受阴道成形术的患者数据。进行描述性分析以阐明患者人口统计学、围手术期特征和 30 天术后结果的模式。
共确定了 183 名患者。中位年龄为 2.41 岁（IQR 0.9 至 12.1）。在该人群中，58.5%的患者为 ASA 2 级，33.3%为 ASA 3 级。先天性畸形占 75.9%。平均总住院时间为 2.7 天（SD=3.8），再入院率为 7.86%。并发症包括尿路感染（3.3%）、出血/输血（2.2%）、器官/空间手术部位感染（1.1%）和浅表切口手术部位感染（0.6%）。同时进行的最常见手术包括膀胱镜检查（n=66）、两性畸形的阴蒂成形术（n=58）和阴道入口的整形修复术（n=22）。
儿科人群的阴道成形术发现 30 天再入院率较低，30 天术后并发症发生率较低。进一步研究关注与儿科阴道成形术相关的前瞻性临床数据可以帮助确定改善该人群长期结果的因素。
