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2019 Fiscal Year Final Research Report

Evaluation of minimally-invasive surgery in children using a nation-wide surgical database

Research Project

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Project/Area Number 16K11340
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Pediatric surgery
Research InstitutionThe University of Tokyo

Principal Investigator

Fujishiro Jun  東京大学, 医学部附属病院, 教授 (60528438)

Co-Investigator(Kenkyū-buntansha) 石丸 哲也  東京大学, 医学部附属病院, 登録研究員 (00633629)
Project Period (FY) 2016-04-01 – 2020-03-31
Keywords小児内視鏡手術 / 手術データベース / 小児急性虫垂炎 / ビッグデータ
Outline of Final Research Achievements

In this study, we focused on the possibility of a nationwide study on the outcome of pediatric endoscopic surgery using NCD data (NCD-P) in the field of pediatric surgery. In this study, we mainly focus on the effectiveness of laparoscopic appendectomy in children. In 4489 cases of appendectomy for pediatric acute appendicitis in 2015 (3166 endoscopic surgery, 1323 open surgery), emergency transport, complicated appendicitis, 15 or less cases of annual pediatric acute appendicitis surgery in the institution were significantly associated with the occurrence of postoperative complications within 30 day after the index operation. Age and laparoscopic surgery were not significant factors for postoperative complications. In a study of complicated appendicitis, drainage significantly increased wound dehiscence, but did not affect the occurrence of intra-abdominal abscess and reoperation. This tendency was similar in subgroup analyses in laparoscopic appendectomy.

Free Research Field

小児外科学

Academic Significance and Societal Importance of the Research Achievements

本研究の成果は、直接的には小児の急性虫垂炎に対する腹腔鏡手術は年齢や重症度(単純性/複雑性)に関わらず合併症率に影響がないこと、複雑性虫垂炎においては腹腔鏡手術例においても虫垂切除時の予防的なドレーン留置は無効で有害な可能性があることを示唆している。全国規模の手術データベースから得られた知見で信頼性は高く、今後の小児急性虫垂炎に対する手術治療を大きく変化させる可能性がある。
また、本研究は小児外科領域におけるビッグデータを用いた研究の可能性を示している。今後同様の研究が発展し国内外の小児医療の向上および小児外科領域の研究発展に大きく寄与することが期待される。

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Published: 2021-02-19  

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