Orchidopexy trends in the paediatric population of Victoria, 1999-2006
Orchidopexy trends in the paediatric population of Victoria, 1999-2006
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DOI：
10.1016/j.jpedsurg.2008.10.099
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发表时间：
2009-02-01
影响因子：
2.4
通讯作者：
Hutson, John
中科院分区：
文献类型：
--
作者：
Bonney, Tamara;Southwell, Bridget;Hutson, John
目的：近年来，媒体对男性生殖健康表示了极大的关注。隐睾是男性不育和睾丸癌的重要原因。推荐的治疗方法是脊柱固定术。最近在英国的研究表明，儿科人群的脊柱固定率下降。因此，在维多利亚的脊柱固定率进行分析，以确定是否存在类似的趋势，什么因素可能有助于这一点。方法：数据提取从医院的记录使用操作代码脊柱固定术的所有患者0至19岁之间的状态维多利亚。维多利亚州的人口数据来自澳大利亚统计局。数据被分为腰椎固定术年龄组0至4，5至9，10至19和跨日历年比较使用图形和统计分析。主要结果：平均而言，手术率0至4岁的患者减少了2.1%，每年在此期间;缩小率的95%可信区间为0.4%~ 3.8%（P < 0.014）。在此期间，5至9岁患者的手术率每年降低6.3%;降低率的95%置信区间为3.7%至8.9%（P <0.005）。在此期间，10至14岁患者的手术率每年降低5.7%;降低率的95%置信区间为1.9%至9.3%（P = 0.003）。结论：在维多利亚州，儿科人群中进行腰椎固定术的数量确实有所下降。这可能代表疾病发生率的真正下降，诊断失败或管理失败。因此，需要进一步调查以确定当前趋势的原因，因为结果可能对男性生殖健康产生重大影响。皇冠版权所有（C）2009年出版的爱思唯尔公司。All rights reserved.
Purpose: In recent times, much concern has been expressed in the media about male reproductive health. Undescended testis is a significant contributor to male infertility and testicular cancer. The recommended management is orchidopexy. Recent studies in the United Kingdom have shown a decline in orchidopexy rates in the paediatric population. An analysis of the orchidopexy rate in Victoria was therefore conducted to determine whether a similar trend existed and what factors may contribute toward this.Methods: Data were extracted from hospital records using operation codes for orchidopexies for all patients between 0 and 19 years in the state of Victoria. Victorian population data were collected from the Australian Bureau of Statistics. Data were grouped into orchidopexy age groups 0 to 4, 5 to 9, and 10 to 19 and compared across calendar years using graphical and statistical analysis.Main Results: On average, the rate of operations on 0 to 4-year-old patients reduced by 2.1% each year over the period; the 95% confidence interval for the rate of reduction was 0.4% to 3.8% (P < 0.014). The rate of operations on 5 to 9-year-old patients reduced by 6.3% each year over the period; the 95% confidence interval for the rate of reduction was 3.7% to 8.9% (P < .005). The rate of operations on 10 to 14-year-old patients reduced by 5.7% each year over the period; the 95% confidence interval for the rate of reduction was 1.9% to 9.3% (P = .003).Conclusion: In the state of Victoria, there has been a true decline in the number of orchidopexy operations done in the paediatric population. This may represent a true decline in the incidence of disease, a failure of diagnosis, or a failure of management. Further investigation will therefore be required to determine the cause of current trends as the outcome may have significant consequences on male reproductive health. Crown Copyright (C) 2009 published by Elsevier Inc. All rights reserved.