Time to event analysis for post-hypospadias repair complications: a single-surgeon experience

Kim, Jin K.; Shiff, Mitchell; Chua, Michael; Zu’bi, Fadi; Ming, Jessica M.; Pokarowski, Martha; Farhat, Walid A.

doi:10.1007/s00345-021-03689-3

Cited by 9 publications

(9 citation statements)

References 14 publications

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“…Rompre et al ( 18 ) reported that the CR of non-distal hypospadias was higher than that of distal hypospadias. Kim et al ( 20 ) and Lucas et al ( 21 ) reported similar results. Previous studies have mainly explored the relationship between the types of hypospadias and complications, and few studies have reported a correlation between the length of specific defective urethra and complications.…”

Section: Discussionsupporting

confidence: 55%

Cumulative sum learning curve analysis of tubularized incised plate repair for hypospadias: a study of a single surgeon with a single surgical procedure

Li,

Zhang,

Diao

et al. 2024

Front. Pediatr.

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PurposeTo ascertain the quantity of instances by which a single surgeon achieves competency and proficiency in using tubularized incised plate (TIP) technique for the repair of distal and mid-shaft hypospadias using the cumulative sum (CUSUM) analysis.MethodsWe retrospectively evaluated patients with distal and mid-shaft hypospadias who were treated by a single surgeon between 2015 and 2021, using a single primary TIP technique with a de-epithelialized Byars flap. Data including type of hypospadias, age at surgery, curvature, operation time (OT), length of the reconstructed urethra, and postoperative outcomes were collected and assessed. CUSUM was used to assess the trends in OT and complication rate (CR) in order to generate the learning curve. The evolution of OT and CR can be divided into three phases: learning, competence, and proficiency.ResultsCUSUM identified three phases in the learning curves of all TIP repairs. The median OT decreased from 135 min [interquartile range (IQR) = 125–155] to 92 min (IQR = 80–100) (P < 0.001), CR decreased from 28 (28%) to 8 (5.3%) (P < 0.001), and reoperations decreased from 15 (15.2%) to 4 (2.6%) (P < 0.001). According to the CUSUM learning curve, technical competency plateaued after the 99th case, and both OT and CR entered a significantly declining proficiency phase after the 231st case. Further, when the neourethral length exceeded the total average, total complications, urethrocutaneous fistula, and reoperations increased (P = 0.013, P = 0.006, and P = 0.028, respectively).ConclusionsOur study suggests that surgeons performing TIP repair may reach technical competency and achieve proficiency after operating on 99,231 cases, respectively. Moreover, the longer the neourethral length, the higher is the CR.

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Section: Discussionsupporting

confidence: 55%

Cumulative sum learning curve analysis of tubularized incised plate repair for hypospadias: a study of a single surgeon with a single surgical procedure

Li,

Zhang,

Diao

et al. 2024

Front. Pediatr.

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“…The finding that most complications occur in the early postoperative period, with a high proportion of complications occurring in those undergoing skin flap-based repairs, is consistent with prior work from our group and others. 5,6 This highlights the importance of early postoperative followup to identify complications at the time of greatest occurrence. We also applaud the authors' commitment to close and systematic postoperative followup with techniques such as routine postoperative photography, and encourage others to follow suit.…”

mentioning

confidence: 99%

Complications after Hypospadias Repair: Are We Adequately Counseling Families?

Rague

Cheng

2022

Journal of Urology

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“…A total of 25% of adults presenting with bulbar strictures had a hypospadias surgery in childhood (117). Penile curvature could appear in 25% of patients within the first 2 years (102,108,110). According to postoperative care, surgeons appear more concerned about the cosmesis than do the parents.…”

Section: Huilin Et Al 2021mentioning

confidence: 99%

Current perspectives in hypospadias research: A scoping review of articles published in 2021 (Review)

Gozar¹,

Bara²,

Dicu³

et al. 2023

Exp Ther Med

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Hundreds of papers are written about hypospadias every year referring to all aspects of the pathology, being one of the most common congenital malformations. The present study conducted a scoping review of articles published in 2021 to present the main issues and summarize current perspectives and achievements in the field. It searched for the keyword 'hypospadias' in the three most popular databases (PubMed, Scopus and Web of Science). After the analysis of the publications, they were categorized into different domains.

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Time to event analysis for post-hypospadias repair complications: a single-surgeon experience

Cited by 9 publications

References 14 publications

Cumulative sum learning curve analysis of tubularized incised plate repair for hypospadias: a study of a single surgeon with a single surgical procedure

Cumulative sum learning curve analysis of tubularized incised plate repair for hypospadias: a study of a single surgeon with a single surgical procedure

Complications after Hypospadias Repair: Are We Adequately Counseling Families?

Current perspectives in hypospadias research: A scoping review of articles published in 2021 (Review)

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