Kefu Du1, Elisabeth E Mulroy2, M Chad Wallis3, Chong Zhang4, Angela P Presson5, Patrick C Cartwright6. 1. Division of Urology, University of Utah, 30 North 1900 East Room 3b110, Salt Lake City, UT 84132, USA. Electronic address: Kefu.Du@hsc.utah.edu. 2. Division of Urology, University of Utah, 30 North 1900 East Room 3b110, Salt Lake City, UT 84132, USA. Electronic address: elissa.mulroy@gmail.com. 3. Division of Urology, University of Utah, 30 North 1900 East Room 3b110, Salt Lake City, UT 84132, USA. Electronic address: Chad.Wallis@hsc.utah.edu. 4. Division of Epidemiology, University of Utah, Williams Building, 295 Chipeta Way, Salt Lake City, UT 84108, USA. Electronic address: Chong.Zhang@hsc.utah.edu. 5. Division of Epidemiology, University of Utah, Williams Building, 295 Chipeta Way, Salt Lake City, UT 84108, USA. Electronic address: Angela.Presson@hsc.utah.edu. 6. Division of Urology, University of Utah, 30 North 1900 East Room 3b110, Salt Lake City, UT 84132, USA. Electronic address: Patrick.Cartwright@hsc.utah.edu.
Abstract
INTRODUCTION: Enterocystoplasty is an important procedure in the management of children with difficult neurogenic bladder. We report on short-term complications as captured by National Surgical Quality Improvement Program (NSQIP) Pediatric. METHODS: We analyzed NSQIP Pediatric 30-day perioperative data on 114 patients who underwent enterocystoplasty in 2012 and compared those with and without complications. RESULTS: Neurogenic bladder was the most common diagnosis. The proportion of the children who underwent two or more procedures was 71.9%, in addition to enterocystoplasty, most commonly appendicovesicostomy. Median length of hospital stay was 8 days (mean 9.7 days, range 2 to 46 days). Thirty-day complication rate was 33.3%, and the most common complications were urinary tract infections (9.6%), wound complications (8.7%), blood transfusions (6.1%), and sepsis (3.5%). Reoperation rate and readmission rate were 9.6% and 13.2%, respectively. No statistically significant differences in perioperative characteristics were found between children with and without postoperative complications. Addition of appendicovesicostomy or bladder neck continence procedures was not associated with significantly increased complications. CONCLUSION: Enterocystoplasty is associated with significant perioperative morbidity, and reasonable expectations should be set during preoperative counseling.
INTRODUCTION: Enterocystoplasty is an important procedure in the management of children with difficult neurogenic bladder. We report on short-term complications as captured by National Surgical Quality Improvement Program (NSQIP) Pediatric. METHODS: We analyzed NSQIP Pediatric 30-day perioperative data on 114 patients who underwent enterocystoplasty in 2012 and compared those with and without complications. RESULTS:Neurogenic bladder was the most common diagnosis. The proportion of the children who underwent two or more procedures was 71.9%, in addition to enterocystoplasty, most commonly appendicovesicostomy. Median length of hospital stay was 8 days (mean 9.7 days, range 2 to 46 days). Thirty-day complication rate was 33.3%, and the most common complications were urinary tract infections (9.6%), wound complications (8.7%), blood transfusions (6.1%), and sepsis (3.5%). Reoperation rate and readmission rate were 9.6% and 13.2%, respectively. No statistically significant differences in perioperative characteristics were found between children with and without postoperative complications. Addition of appendicovesicostomy or bladder neck continence procedures was not associated with significantly increased complications. CONCLUSION: Enterocystoplasty is associated with significant perioperative morbidity, and reasonable expectations should be set during preoperative counseling.
Authors: Alexander C Small; Alejandra Perez; Jayant Radhakrishnan; Stanley Desire; Philip Zachariah; Lisa C Creelman; Shumyle Alam Journal: Pediatr Surg Int Date: 2018-08-01 Impact factor: 1.827
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