Guideline implementation for the treatment of undescended testes: Still room for improvement.
J Pediatr Surg
; 53(11): 2219-2224, 2018 Nov.
Article
em En
| MEDLINE
| ID: mdl-29884555
ABSTRACT
BACKGROUND:
Early orchidopexy (OP) around the age of 1 year is recommended in boys with congenital undescended testis (UDT) worldwide since decades. Former retrospectives studies did not distinguish congenital from acquired UDT with a consecutive negative bias concerning the age at surgery.METHODS:
In a retrospective analysis, data of all boys who underwent OP in eight pediatric surgery institutions from 2009 to 2015 were analyzed. Congenital or acquired UDT were differentiated. Patients were categorized into 3 groups of age at surgery (1) <12â¯months, (2) 12-24â¯months, (3) >24â¯months. Data of one institution were analyzed in detail exact age of first referral, exact age at surgery, intraoperative findings.RESULTS:
Out of 4448 boys, 3270 boys had congenital UDT. In 81% (2656 cases) surgery was performed beyond the age of 1 year, in 54.4% (1780) beyond the age of 2 years. chi-Square statistics showed a higher rate of early operations in hospitals compared to outpatient services and in Germany compared to Switzerland. In 694 congenital detailed cases, median age at referral was 13â¯months [range 0-196], median age at surgery was 15â¯months [range 0-202].CONCLUSION:
Delayed referral is the main reason for guideline non-conform delayed surgery in UDT. TYPE OF STUDY Clinical Research paper. LEVEL OF EVIDENCE Level III Treatment Study.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Criptorquidismo
Tipo de estudo:
Guideline
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Observational_studies
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Risk_factors_studies
Limite:
Child, preschool
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2018
Tipo de documento:
Article