Trends in Histrelin Implantation at a Pediatric Tertiary Care Center.
Trends in Histrelin Implantation at a Pediatric Tertiary Care Center.
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儿科三级护理中心组氨瑞林植入趋势。
DOI：
10.1016/j.jss.2023.05.019
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Nance,MichaelL
中科院分区：
文献类型：
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作者：
Mak,Allison;Hwang,Rosa;NaceJr,Gary;Allukian3rd,Myron;Nance,MichaelL
回顾性分析2008年1月至2022年4月间接受histrelin植入的所有患者的手术结果，并确定15年以上儿童三级保健中心接受histrelin植入的患者使用的变化趋势。结果746例患者共进行了1794例独特手术（1364例放置/替换，430例移除）。手术分别在诊所（1071例，占60%）、镇静病房（630例，占35%）和手术室（93%，占5%）进行。共发现14例（0.8%）并发症，其中2例患者需要早期移除种植体，1例患者需要抗生素。植入物用于中枢性性早熟（CPP, 579）或性别焦虑症（GD, 167）。男性占25.9%，女性占74.1%，平均着床年龄9.48 y （SD: 2.34，范围：1.05 ~ 17.34）。GD组中男性占52.4%，女性占47.6%，而CPP组中男性占18.3%，女性占81.7%。不同适应症的平均放置年龄有显著差异（CPP 8.65 vs usgd 12.34，P< 0.001）。新患者转诊和植入手术在14年内显著增加。每年接受CPP和GD植入的患者频率显著增加（P< 0.001）， GD患者的比例从7%增加到32%。结论：shistrelin治疗的频率总体上有所增加，GD队列的增加幅度更大。精简流程和专业团队的发展使histrelin手术在大多数临床环境中安全进行，并发症发生率非常低。
IntroductionDetermine procedural outcomes and identify changing trends of utilization among patients undergoing histrelin implantation at a large pediatric tertiary care center over 15 y.MethodsRetrospective review of all patients undergoing histrelin implantation between January 2008 and April 2022.ResultsA total of 746 patients underwent 1794 unique procedures (1364 placements/replacements, 430 removals). Procedures were performed in the clinic (1071, 60%), sedation unit (630, 35%), and operating room (93, 5%). A total of 14 (0.8%) complications were identified, including two patients that required early implant removal and one patient requiring antibiotics. Implants were placed for central precocious puberty (CPP, 579) or gender dysphoria (GD, 167). Cohort included 25.9% males and 74.1% females with mean age of implantation of 9.48 y (SD: 2.34, range: 1.05-17.34). The GD group is comprised of 52.4% males and 47.6% females, compared to 18.3% males and 81.7% females in the CPP. Significant difference was identified for mean age at placement by indication (CPP 8.65 yversusGD 12.34,P< 0.001). New patient referrals and implant procedures increased significantly over 14 y. Yearly frequency of patients receiving implants for CPP and GD increased significantly (P< 0.001), with proportion of GD patients increasing from 7% to 32%.ConclusionsHistrelin procedures have increased in frequency overall with the greater increase noted in the GD cohort. The development of a streamlined process and a dedicated team have enabled histrelin procedures to be safely performed in the clinic setting for most, with a very low complication rate.