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基于列线图对附睾覆盖术后尿道下裂患者术后并发症的预测

Nomogram-based prediction of postoperative complications in patients with hypospadias after perididymis covering.

作者信息

Dong Jin-Ming, Gao Ya-Ke, Yang Yan-Dong, Shi Yi-Qun, Zhang Li-Na, Liu Jing, Zhao Hai-Jun, Zhao Xiao-Bo

机构信息

Department of Pediatric Surgery, Tangshan Maternal and Child Health Center, Tangshan, China.

Department of Traditional Medical Chinese Gynecology, Shijiazhuang Fourth Hospital, Shijiazhuang, China.

出版信息

Transl Pediatr. 2025 Jan 24;14(1):61-69. doi: 10.21037/tp-24-368. Epub 2025 Jan 21.

Abstract

BACKGROUND

Hypospadias is a prevalent pediatric urological condition. Perididymis covering is often used as a surgical procedure for the treatment of hypospadias. This study aims to investigate the risk factors associated with postoperative complications following perididymis covering in the treatment of hypospadias.

METHODS

This study involved 204 patients with hypospadias who underwent perididymis cove ring at Tangshan Maternal and Child Health Hospital from May 2018 to May 2024. Patients were followed up for 1 year, with 63 experiencing complications (30.88%) and 141 not experiencing complications (69.12%). Baseline data from both groups were collected and compared. Binary logistic regression analysis was used to analyze the relationship between various factors and postoperative complications. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were utilized to evaluate the predictive value of the nomogram model for postoperative complications.

RESULTS

The complication group had a higher mean age and longer formed urethra lengths compared to the non-complication group. The types of hypospadias were categorized as intermediate, proximal, and those associated with preoperative penile curvature. The AUC for the nomogram model in the prediction of the postoperative complications was 0.909 [95% confidence interval (CI): 0.866-0.952], with a sensitivity of 0.746, a specificity of 0.929, and a Youden's index of 0.675.

CONCLUSIONS

Age, length of the formed urethra, types of hypospadias, preoperative penile curvature, and surgical methods are significantly associated with postoperative complications following perididymis covering in patients with hypospadias. These indicators can guide the formulation of clinical treatment plans to reduce the incidence of postoperative complications.

摘要

背景

尿道下裂是一种常见的小儿泌尿系统疾病。附睾覆盖术常被用作治疗尿道下裂的手术方法。本研究旨在探讨尿道下裂治疗中附睾覆盖术后并发症的相关危险因素。

方法

本研究纳入了2018年5月至2024年5月在唐山市妇幼保健院接受附睾覆盖术的204例尿道下裂患者。对患者进行1年的随访,其中63例出现并发症(30.88%),141例未出现并发症(69.12%)。收集并比较两组的基线数据。采用二元逻辑回归分析各种因素与术后并发症之间的关系。利用受试者工作特征(ROC)曲线和曲线下面积(AUC)评估列线图模型对术后并发症的预测价值。

结果

与无并发症组相比,并发症组的平均年龄更高,已形成尿道长度更长。尿道下裂类型分为中度、近端型以及与术前阴茎弯曲相关的类型。列线图模型预测术后并发症的AUC为0.909 [95%置信区间(CI):0.866 - 0.952],灵敏度为0.746,特异度为0.929,约登指数为0.675。

结论

年龄、已形成尿道长度、尿道下裂类型、术前阴茎弯曲和手术方法与尿道下裂患者附睾覆盖术后并发症显著相关。这些指标可指导临床治疗方案的制定,以降低术后并发症的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e86/11811594/22db908a7ead/tp-14-01-61-f1.jpg

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