Abstract：
BACKGROUND: The high prevalence of benign male breast tissue enlargement (gynecomastia) has resulted in a marked increase of gynecomastia cases. While about one third of male adults experience some form of gynecomastia, gynecomastia surgery (GS) outcome research is limited to small study populations and single-center/-surgeon databases. In this study, we aimed to access the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to identify preoperative risk factors for complications and investigate postoperative outcomes of GS.
METHODS: In this retrospective study, we queried the ACS-NSQIP database from 2008 to 2021 to identify male adult patients who underwent GS. Postoperative outcomes involved the occurrence of any, surgical and medical complications, as well as reoperation, readmission, and mortality within a 30-day postoperative time period. Univariable and multivariable assessment were performed to identify risk factors for complications while adjusting for possible confounders.
RESULTS: The study included 4,996 GS patients with a mean age of 33.7 ± 15 years and BMI of 28.2 ± 5.1 kg/m2. White patients constituted 54% (n = 2713) of the cohort, and 27% (n = 1346) were obese. Except for 2020, there was a steady increase in GS cases over the study period. Outpatient surgeries were most common at 95% (n = 4730), while general surgeons performed the majority of GS (n = 3580; 72%). Postoperatively, 91% (n = 4538) of patients were discharged home; 4.4% (n = 222) experienced any complications. Multivariable analysis identified inpatient setting (p < 0.001), BMI (p = 0.023), prior sepsis (p = 0.018), and bleeding disorders (p = 0.047) as independent risk factors for complications.
CONCLUSIONS: In this study, we analyzed 4996 male adult GS patients from the ACS-NSQIP database, revealing an increased caseload and significant general surgeon involvement. Risk factors like bleeding disorders, inpatient status, and prior sepsis were linked to postoperative complications, while BMI was crucial for predicting adverse events. Overall, our findings may aid in enhancing patient care through advanced preoperative screening and closer perioperative management.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: In this retrospective study, we queried the ACS-NSQIP database from 2008 to 2021 to identify male adult patients who underwent GS. Postoperative outcomes involved the occurrence of any, surgical and medical complications, as well as reoperation, readmission, and mortality within a 30-day postoperative time period. Univariable and multivariable assessment were performed to identify risk factors for complications while adjusting for possible confounders.
RESULTS: The study included 4,996 GS patients with a mean age of 33.7 ± 15 years and BMI of 28.2 ± 5.1 kg/m2. White patients constituted 54% (n = 2713) of the cohort, and 27% (n = 1346) were obese. Except for 2020, there was a steady increase in GS cases over the study period. Outpatient surgeries were most common at 95% (n = 4730), while general surgeons performed the majority of GS (n = 3580; 72%). Postoperatively, 91% (n = 4538) of patients were discharged home; 4.4% (n = 222) experienced any complications. Multivariable analysis identified inpatient setting (p < 0.001), BMI (p = 0.023), prior sepsis (p = 0.018), and bleeding disorders (p = 0.047) as independent risk factors for complications.
CONCLUSIONS: In this study, we analyzed 4996 male adult GS patients from the ACS-NSQIP database, revealing an increased caseload and significant general surgeon involvement. Risk factors like bleeding disorders, inpatient status, and prior sepsis were linked to postoperative complications, while BMI was crucial for predicting adverse events. Overall, our findings may aid in enhancing patient care through advanced preoperative screening and closer perioperative management.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
背景：良性男性乳腺组织增大（男性乳房发育症）的高患病率导致男性乳房发育症病例明显增加。虽然大约三分之一的男性成年人经历某种形式的男性乳房发育症，妇科乳房发育症手术(GS)结局研究仅限于小型研究人群和单中心/外科医生数据库.在这项研究中,我们旨在访问美国外科医师学会国家外科质量改善计划(ACS-NSQIP)数据库,以确定并发症的术前危险因素,并调查GS的术后结局.
方法：在这项回顾性研究中，我们查询了2008年至2021年的ACS-NSQIP数据库,以确定接受GS的男性成年患者.术后结果涉及任何，外科和内科并发症，以及重新手术，重新接纳,以及术后30天内的死亡率。进行单变量和多变量评估以确定并发症的危险因素，同时调整可能的混杂因素。
结果：该研究包括4,996名GS患者，平均年龄为33.7±15岁，BMI为28.2±5.1kg/m2。白人患者占队列的54％（n=2713），27%(n=1346)肥胖。除2020年外，研究期间GS病例稳步增加。门诊手术最常见，占95%(n=4730)，而普通外科医生完成了大部分GS（n=3580；72％）。术后,91％（n=4538）的患者出院；4.4％（n=222）出现任何并发症。多变量分析确定了住院设置（p<0.001），BMI（p=0.023），既往脓毒症(p=0.018)，出血性疾病（p=0.047）是并发症的独立危险因素。
结论：在这项研究中，我们分析了来自ACS-NSQIP数据库的4996名男性成年GS患者，显示病例数增加和普通外科医生的参与显著。出血性疾病等危险因素,住院情况,以前的败血症与术后并发症有关，而BMI对于预测不良事件至关重要。总的来说,我们的研究结果可能有助于通过先进的术前筛查和更紧密的围手术期管理来加强患者护理.
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：在这项回顾性研究中，我们查询了2008年至2021年的ACS-NSQIP数据库,以确定接受GS的男性成年患者.术后结果涉及任何，外科和内科并发症，以及重新手术，重新接纳,以及术后30天内的死亡率。进行单变量和多变量评估以确定并发症的危险因素，同时调整可能的混杂因素。
结果：该研究包括4,996名GS患者，平均年龄为33.7±15岁，BMI为28.2±5.1kg/m2。白人患者占队列的54％（n=2713），27%(n=1346)肥胖。除2020年外，研究期间GS病例稳步增加。门诊手术最常见，占95%(n=4730)，而普通外科医生完成了大部分GS（n=3580；72％）。术后,91％（n=4538）的患者出院；4.4％（n=222）出现任何并发症。多变量分析确定了住院设置（p<0.001），BMI（p=0.023），既往脓毒症(p=0.018)，出血性疾病（p=0.047）是并发症的独立危险因素。
结论：在这项研究中，我们分析了来自ACS-NSQIP数据库的4996名男性成年GS患者，显示病例数增加和普通外科医生的参与显著。出血性疾病等危险因素,住院情况,以前的败血症与术后并发症有关，而BMI对于预测不良事件至关重要。总的来说,我们的研究结果可能有助于通过先进的术前筛查和更紧密的围手术期管理来加强患者护理.
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
