■Ladd\'sprocedure,最初描述于1936年,用于治疗旋转不良,传统上不包括阑尾切除术作为标准步骤。我们进行了一项跨国调查,以调查目前关于阑尾切除术在Ladd手术中的作用的共识。
■一项匿名的在线调查被分发给世界各地的儿科外科医生。该调查收集了人口统计数据,并探讨了与旋转不良管理相关的手术偏好。开放式问题被用来评估关于阑尾切除术必要性的意见,决策因素,以及与Ladd手术期间阑尾切除术相关的并发症。
■共收到来自46个国家/地区的343份答复。在受访者中,319名(93%)是顾问,24名(7%)是居民/受训人员。当被问及开腹手术和腹腔镜手术之间的选择时,292(85%)首选开腹手术。总的来说,184名(53%)受访者赞成在开腹和腹腔镜Ladd手术中进行阑尾切除术。此外,172(50%)外科医生提倡在所有旋转不良病例中进行阑尾切除术,出于对未来潜在阑尾炎的担忧。虽然所有比较之间都存在差异,均无统计学意义。影响决定保留阑尾的因素包括术后并发症的风险以及阑尾作为手术导管的潜在未来用途。阑尾切除术后的手术并发症包括14例(33%)患者的手术部位感染,13例(31%)患者粘连性梗阻,10例(24%)患者发生腹内脓肿,5例(12%)患者的粪便瘘。
■大多数外科医生的目标是在所有旋转不良病例中进行阑尾切除术,考虑到这种方法的潜在风险和好处。这些发现为临床实践提供了宝贵的见解,并可能为未来的指南和决策算法提供信息。
UNASSIGNED: Ladd\'s procedure, originally described in 1936 for the treatment of
malrotation, does not traditionally include appendectomy as a standard step. We conducted a multinational survey to investigate the current consensus on the role of appendectomy in Ladd\'s procedure.
UNASSIGNED: An anonymous online survey was distributed to pediatric surgeons worldwide. The survey collected demographic data and explored surgical preferences related to the management of
malrotation. Open-ended questions were used to assess the opinions regarding the necessity of appendectomy, decision-making factors, and complications associated with appendectomy during Ladd\'s procedure.
UNASSIGNED: A total of 343 responses were received from 46 countries. Of the respondents, 319 (93%) were consultants and 24 (7%) were residents/trainees. When asked about the choice between open and laparoscopic Ladd\'s procedure, 292 (85%) preferred open surgery. Overall, 184 (53%) respondents favored appendectomy in both open and laparoscopic Ladd\'s procedure. Furthermore, 172 (50%) surgeons advocated for appendectomy in all
malrotation cases, citing concerns about potential future appendicitis. While differences existed between all comparisons, none of them reached statistical significance. The factors influencing the decision to preserve the appendix included the risk of postoperative complications and the potential future use of the appendix as a surgical conduit. The surgical complications following appendectomy included surgical site infections in 14 (33%) patients, adhesive obstruction in 13 (31%) patients, intrabdominal abscesses in 10 (24%) patients, and fecal fistulas in 5 (12%) patients.
UNASSIGNED: The majority of surgeons aim to perform appendectomy in all
malrotation cases, considering the potential risks and benefits of this approach. These findings offer valuable insights for clinical practice and may inform future guidelines and decision-making algorithms.