The burden of revision sinonasal surgery in the UK-data from the Chronic Rhinosinusitis Epidemiology Study (CRES): a cross-sectional study

被引：102

作者：

Philpott, Carl ^{[1
,2
,3
]}

Hopkins, Claire ^{[4
]}

Erskine, Sally ^{[1
]}

Kumar, Nirmal ^{[5
]}

Robertson, Alasdair ^{[6
]}

Farboud, Amir ^{[7
]}

Ahmed, Shahzada ^{[8
]}

Anari, Shahram ^{[9
]}

Cathcart, Russell ^{[10
]}

Khalil, Hisham ^{[11
]}

Jervis, Paul ^{[12
]}

Carrie, Sean ^{[13
]}

Kara, Naveed ^{[14
]}

Prinsley, Peter ^{[15
]}

Almeyda, Robert ^{[16
]}

Mansell, Nicolas ^{[17
]}

Sunkaraneni, Sankalp ^{[18
]}

Salam, Mahmoud ^{[19
]}

Ray, Jaydip ^{[20
]}

Panesaar, Jaan ^{[21
]}

Hobson, Jonathan ^{[22
]}

Clark, Allan ^{[4
]}

Morris, Steve ^{[23
]}

机构：

[1] James Paget Univ Hosp NHS Fdn Trust, Gorleston, England

[2] Univ E Anglia, Norwich Med Sch, Norwich NR4 7TJ, Norfolk, England

[3] Spire Norwich Hosp, Norwich, Norfolk, England

[4] Guys & St Thomas Hosp, London SE1 9RT, England

[5] Wrightington Wigan & Leigh NHS Fdn Trust, Wigan, England

[6] So Gen Hosp, Glasgow G51 4TF, Lanark, Scotland

[7] Wrexham Maelor Hosp, Wrexham, Wales

[8] Univ Hosp Birmingham, Birmingham, W Midlands, England

[9] Heart England NHS Fdn Trust, Birmingham, W Midlands, England

[10] Cumberland Infirm, Carlisle, PA USA

[11] Derriford Hosp, Plymouth PL6 8DH, Devon, England

[12] Northampton Gen Hosp, Northampton, England

[13] Freeman Rd Hosp, Newcastle Upon Tyne NE7 7DN, Tyne & Wear, England

[14] Sunderland Royal Infirm, Newcastle Upon Tyne, Tyne & Wear, England

[15] Norfolk & Norwich Univ Hosp, Norwich, Norfolk, England

[16] Oxford Univ Hosp, Oxford, England

[17] Royal Berkshire NHS Fdn Trust, Reading, Berks, England

[18] Royal Surrey Cty Hosp, Guildford, Surrey, England

[19] Ipswich Hosp, Ipswich, Suffolk, England

[20] Sheffield Teaching Hosp, Sheffield, S Yorkshire, England

[21] Luton & Dunstable Hosp, Luton, Beds, England

[22] Warrington & Halton Hosp NHS Fdn Trust, Warrington, Cheshire, England

[23] UCL, Dept Appl Hlth Res, London, England

来源：

BMJ OPEN | 2015年 / 5卷 / 04期

关键词：

ENDOSCOPIC SINUS SURGERY; NATIONAL COMPARATIVE AUDIT; NASAL POLYPOSIS; MEDICAL THERAPY; RISK-FACTORS; FOLLOW-UP; RECURRENCE; PREVALENCE; OUTCOMES; QUALITY;

D O I：

10.1136/bmjopen-2014-006680

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: The aim of this study was to investigate the surgical revision rate in patients with chronic rhinosinusitis (CRS) in the UK CRS Epidemiology Study (CRES). Previous evidence from National Sinonasal Audit showed that 1459 patients with CRS demonstrated a surgical revision rate 19.1% at 5 years, with highest rates seen in those with polyps (20.6%). Setting: Thirty secondary care centres around the UK. Participants: A total of 221 controls and 1249 patients with CRS were recruited to the study including those with polyps (CRSwNPs), without polyps (CRSsNPs) and with allergic fungal rhinosinusitis (AFRS). Interventions: Self-administered questionnaire. Primary outcome measure: The need for previous sinonasal surgery. Results: A total of 651 patients with CRSwNPs, 553 with CRSsNPs and 45 with AFRS were included. A total of 396 (57%) patients with CRSwNPs/AFRS reported having undergone previous endoscopic nasal polypectomy (ENP), of which 182 of the 396 (46%) reported having received more than one operation. The mean number of previous surgeries per patient in the revision group was 3.3 (range 2-30) and a mean duration of time of 10 years since the last procedure. The average length of time since their first operation up to inclusion in the study was 15.5 years (range 0-74). Only 27.9% of all patients reporting a prior ENP had received concurrent endoscopic sinus surgery (ESS; n=102). For comparison, surgical rates in patients with CRSsNPs were significantly lower; 13% of cases specifically reported ESS, and of those only 30% reported multiple procedures (chi(2) p<0.001). Conclusions: This study demonstrated that there is a high burden of both primary and revision surgery in patients with CRS, worst in those with AFRS and least in those with CRSsNPs. The burden of revision surgery appears unchanged in the decade since the Sinonasal Audit.

引用

页数：8

共 25 条

[11]

Hopkins C, 2013, COMMISSIONING GUIDE

[12] Long-Term Outcomes From the English National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis [J].