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Poster Display - 23
Too late to catch it? Rethinking routine follow-up after pediatric circumcision
Ana Isabel Barros, Mário Rui Correia, Jorge Cagigal, Joana Sinde, Catarina Sousa-Lopes, Maria Luisa Gaspar, José Banquart-Leitão, Catarina Carvalho
Department of Pediatric Surgery of Unidade Local de Saúde de Santo António
Purpose: Postoperative follow-up visits are essential in any surgical patient recovery process, as permits detection of potential early complications. However, their time frames are very wide and surgeon dependent. Optimizing the standard follow-up timing may improve resource allocation and patient care. We aimed to define this ideal timing after one of the most common procedures in pediatric surgery: circumcision.
Method: A retrospective study was conducted in all patients who underwent circumcision in our department from January/2022 to December/2023. Age, time to first visit, total follow-up duration, number of visits, complications’ presence and timing were collected. Descriptive statistics summarized data and analyzed complication patterns using SPSS V30.
Results: A total of 516 patients were included, with a median age of 8.5 years (0-18 years). Median time to the first visit was 3.5 weeks, and 73.6% were discharged after that first consultation. Overall, complication’s rate was 18.4%, with median time to diagnosis of 1.5 weeks (0-56 weeks). Notably, 48.8% of complications occurred before scheduled follow-up visit. Regarding diagnostic settings, 50.5% were diagnosed in the emergency department and 43.2% during surgical outpatient visits. Preputial lymphedema (29.5%), dehiscence (17.9%), hematoma (13.7%), and surgical site infection (12.6%) were the most common complications. All recurrences (5.3%) and one dehiscence were reintervented. Cumulative complication timing analysis revealed: 37.9% of complications were diagnosed by postoperative week-1, 61.1% by week-2, and 71.3% by week-3. By week-4, 84.2% of all complications had been diagnosed, increasing to 90.5% by week-6.
Conclusion: Nearly half of all complications occurred before the scheduled visit, and over 70% were diagnosed within the first three postoperative weeks. These findings suggest that adjusting the standard follow-up to occur between the 2nd and 3rd postoperative week could increase clinical utility, reduce emergency department reliance, and improve resource allocation.