■描述在手术训练后的头三年内,由一名受过新训练的外科医生进行动力式内窥镜泪囊鼻腔吻合术(PEnDCR)的时间和长期结果的变化。
■在2016年10月至2020年2月期间,对所有接受原发性或修订PEnDCR的患者进行了回顾性干预分析。获得的数据包括人口统计,介绍,以前的干预措施,术前内窥镜检查结果,术中发现,术后并发症,和结果。术中特征,如Boezaart手术野量表,辅助鼻内手术,并记录了该程序所需的时间。最后分析考虑至少随访12个月。使用软件R(v4.1.2)进行统计学分析。
■共有155名患者的159只眼接受了PEnDCR,其中141只眼是初级手术。平均年龄为64.28岁,M:F比为1:2.5。第一年后每年执行的病例数稳步上升,辅助鼻内手术也是如此。平均手术时间显示有和没有辅助鼻内手术的手术平均减少了10.80和12.81分钟(p<.001)。大多数(77.3%,123/159)的术中视野在Boezaart量表上被分类为3级。手术后使用丝裂霉素C的实践在三年内显著且稳定地减少(p<.001)。出血和肉芽肿形成是术后常见的不良发现,并显示出超过第一年的显着下降(p<.001)。解剖和功能成功率为(96.18%,91.72%),(95.71%,92.14%),和(96.16%,91.94%),分别,在12、24和36个月的随访。
■PEnDCR患者的一些术中和术后参数显示出超过独立实践第一年的改善。从长远来看,成功率保持得很好。
UNASSIGNED: To describe the changes in the time taken and the long-term outcomes of powered endoscopic dacryocystorhinostomy (PEnDCR) performed by a freshly trained surgeon in the first three years following the surgical training.
UNASSIGNED: A retrospective interventional analysis was performed on all patients who underwent a primary or a revision PEnDCR from October 2016 to February 2020. Data obtained include demographics, presentation, previous interventions, pre-operative endoscopy findings, intra-operative findings, post-operative complications, and outcomes. Intra-operative features like the Boezaart surgical field scale, adjunctive endonasal procedures, and time taken for the procedure were noted. A minimum follow-up of 12 months was considered for final analysis. Statistical analysis was performed using software R (v 4.1.2).
UNASSIGNED: A total of 159 eyes of 155 patients underwent PEnDCR, of which 141 eyes were primary surgeries. The mean age was 64.28 years, with M:F ratio being 1:2.5. The number of cases performed per year steadily increased after the first year, and so was the case with adjunctive endonasal procedures. The mean procedure time showed an average reduction by 10.80 and 12.81 minutes for surgeries with and without adjunctive endonasal procedures (p < .001). The majority (77.3%, 123/159) of the intra-operative fields were classified as Grade 3 on the Boezaart scale. The practice of post-operative mitomycin C use significantly and steadily reduced over the three years (p < .001). Bleeding and granuloma formation were the common undesirable post-operative findings and showed a significant (p < .001) decline beyond the first year. The anatomical and functional success were (96.18%, 91.72%), (95.71%, 92.14%), and (96.16%, 91.94%), respectively, at 12, 24 and 36 months follow up.
UNASSIGNED: Several intra-operative and post-operative parameters of PEnDCR patients showed improvement beyond the first year of independent practice. The success rates were well-maintained in the long term.