Serious complications and risk of re-operation after Dupuytren's disease surgery: a population-based cohort study of 121,488 patients in England.
Serious complications and risk of re-operation after Dupuytren's disease surgery: a population-based cohort study of 121,488 patients in England.
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DOI：
10.1038/s41598-020-73595-y
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发表时间：
2020-10-05
影响因子：
4.6
通讯作者：
Furniss D
中科院分区：
文献类型：
--
作者：
Alser O;Craig RS;Lane JCE;Prats-Uribe A;Robinson DE;Rees JL;Prieto-Alhambra D;Furniss D
Dupuytren病（DD）是一种常见的手掌纤维增生性疾病。我们估计了DD手术后严重局部和全身并发症以及再次手术的风险。我们查询了英格兰的医院事件统计数据库，包括所有接受手术治疗的成人DD患者。进行纵向队列研究和自身对照病例系列研究。在2007年4月1日至2017年3月31日期间，121，488名成年人接受了158，119次DD手术。90天严重局部并发症的累积发生率较低，为1.2%（95% CI 1.1-1.2）。然而，皮筋膜切除术后行有限筋膜切除术再次手术的截肢率为8%。90-日间全身性并发症也不常见，为0.78%（95% CI 0.74-0.83），然而，在全身或区域麻醉下常规进行的手术增加了严重全身性并发症（如心肌梗死）的风险。再次手术率低于既往报告（经皮针筋膜切开术为33.7%，有限筋膜切除术为19.5%，皮筋膜切除术为18.2%）。总体而言，在英国进行的DD手术是安全的;然而，皮筋膜切除术后再次手术具有较高的截肢风险。此外，虽然严重的全身性并发症是罕见的，数据表明，高风险的患者应接受局部麻醉下的治疗。这些数据将为有关这种常见情况的更好的共享决策提供信息。
Dupuytren’s disease (DD) is a common fibro-proliferative disorder of the palm. We estimated the risk of serious local and systemic complications and re-operation after DD surgery. We queried England’s Hospital Episode Statistics database and included all adult DD patients who were surgically treated. A longitudinal cohort study and self-controlled case series were conducted. Between 1 April 2007 and 31 March 2017, 121,488 adults underwent 158,119 operations for DD. The cumulative incidence of 90-day serious local complications was low at 1.2% (95% CI 1.1–1.2). However, the amputation rate for re-operation by limited fasciectomy following dermofasciectomy was 8%. 90-day systemic complications were also uncommon at 0.78% (95% CI 0.74–0.83), however operations routinely performed under general or regional anaesthesia carried an increased risk of serious systemic complications such as myocardial infarction. Re-operation was lower than previous reports (33.7% for percutaneous needle fasciotomy, 19.5% for limited fasciectomy, and 18.2% for dermofasciectomy). Overall, DD surgery performed in England was safe; however, re-operation by after dermofasciectomy carries a high risk of amputation. Furthermore, whilst serious systemic complications were unusual, the data suggest that high-risk patients should undergo treatment under local anaesthesia. These data will inform better shared decision-making regarding this common condition.
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影响因子：
3.7
作者：
Kan, Hester J.;Verrijp, Frank W.;Selles, Ruud W.
通讯作者：
Selles, Ruud W.
DOI：
10.1302/0301-620x.82b1.9808
发表时间：
2000-01-01
影响因子：
--
作者：
Armstrong, JR;Hurren, JS;Logan, AM
通讯作者：
Logan, AM
DOI：
10.1302/0301-620x.74b6.1447259
发表时间：
1992-11-01
影响因子：
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作者：
SANDERSON, PL;MORRIS, MA;FAHMY, NRM
通讯作者：
FAHMY, NRM
影响因子：
3.6
作者：
van Rijssen, Annet L.;ter Linden, Hein;Werker, Paul M. N.
通讯作者：
Werker, Paul M. N.
影响因子：
9.8
作者：
Ng, Michael;Thakkar, Dipti;Furniss, Dominic
通讯作者：
Furniss, Dominic