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评估内镜辅助颅缝早闭手术的学习曲线和患者预后：一项20年的分析。

Evaluating the Learning Curve and Patient Outcomes in Endoscopically Assisted Craniosynostosis Surgery: A 20-Year Analysis.

作者信息

Chargi Najiba, Kregel Mark, Xi Tong, Dormaar Titiaan, Borstlap Wilfred, van Lindert Erik, Delye Hans, Nienhuijs Marloes

机构信息

Department of Oral and Maxillofacial Surgery, Radboud University Medical Center.

Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

J Craniofac Surg. 2025;36(1):123-127. doi: 10.1097/SCS.0000000000010755. Epub 2024 Oct 11.

DOI:10.1097/SCS.0000000000010755
PMID:39730009
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11658016/
Abstract

OBJECTIVES

To analyze the learning curve associated with endoscopic-assisted craniosynostosis surgery (EACS) at a single institution over a period of 2 decades.

MATERIAL AND METHODS

Patients who underwent EACS between 2004 and 2023 were included in this retrospective study. The impact of surgical experience was assessed by analyzing the duration of surgery and anesthesia, blood loss, need for blood transfusion, postoperative complications, and length of hospital stay, in relation to the number of surgeries performed.

RESULTS

On the basis of 310 patients, the overall complication rate was low, with only 23 patients (7.4%) experiencing postoperative complications and 33 patients (10.6%) requiring a blood transfusion. The median length of hospital stay was 3 days (range 1-7 days). The results showed a statistically significant learning curve associated with EACS, with each additional surgery reducing the odds of postoperative complications by 0.7% ( P <0.001) and the odds of blood transfusion by 0.8% ( P <0.001). In addition, there were significant reductions in the duration of anesthesia, duration of surgery, and length of hospital stay over time ( P <0.001).

CONCLUSION

EACS is a safe and effective technique for treating craniosynostosis with low complication rates and a significant learning curve over time. Surgeons can expect to achieve better outcomes with greater surgical experience.

摘要

目的

分析在一家机构20年期间与内镜辅助颅缝早闭手术（EACS）相关的学习曲线。

材料与方法

本回顾性研究纳入了2004年至2023年期间接受EACS手术的患者。通过分析手术和麻醉持续时间、失血量、输血需求、术后并发症以及住院时间与手术例数的关系，评估手术经验的影响。

结果

基于310例患者，总体并发症发生率较低，仅有23例患者（7.4%）出现术后并发症，33例患者（10.6%）需要输血。中位住院时间为3天（范围1 - 7天）。结果显示与EACS相关存在统计学显著的学习曲线，每增加一例手术，术后并发症的几率降低0.7%（P <0.001），输血几率降低0.8%（P <0.001）。此外，随着时间推移，麻醉持续时间、手术持续时间和住院时间均有显著缩短（P <0.001）。

结论

EACS是一种治疗颅缝早闭的安全有效技术，并发症发生率低，且随着时间推移存在显著的学习曲线。外科医生手术经验越丰富，预期效果越好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27b1/11658016/f7b51120cdc7/scs-36-123-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27b1/11658016/32e6f627f17b/scs-36-123-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27b1/11658016/f7b51120cdc7/scs-36-123-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27b1/11658016/32e6f627f17b/scs-36-123-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27b1/11658016/4efef32c1410/scs-36-123-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27b1/11658016/cca39abfe1d7/scs-36-123-g003.jpg
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本文引用的文献

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单缝颅缝早闭的治疗回顾：过去、现在与未来
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