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Enterocystoplasty 30-day outcomes from National Surgical Quality Improvement Program Pediatric 2012
Kefu Du1, Elisabeth E Mulroy1, M Chad Wallis1
1Division of Urology, University of Utah, 30 North 1900 East Room 3b110, Salt Lake City, UT 84132, USA.
Insights
Enterocystoplasty in children with neurogenic bladder has a 33.3% complication rate, including infections and wound issues. Surgeons should counsel families on significant perioperative morbidity risks.
Area of Science:
- Pediatric Urology
- Surgical Quality Improvement
- Bladder Reconstruction
Background:
- Enterocystoplasty is a key procedure for managing pediatric neurogenic bladder.
- This study examines short-term complications using the National Surgical Quality Improvement Program (NSQIP) Pediatric database.
Purpose of the Study:
- To analyze the 30-day perioperative complication rates associated with enterocystoplasty in children.
- To identify factors influencing complications and outcomes.
Main Methods:
- Analysis of 114 pediatric patients undergoing enterocystoplasty in 2012 from the NSQIP Pediatric database.
- Comparison of patients with and without 30-day postoperative complications.
Main Results:
- Neurogenic bladder was the most frequent diagnosis; 71.9% of patients had multiple procedures.
- The 30-day complication rate was 33.3%, with common issues including UTIs, wound complications, and sepsis.
- Reoperation and readmission rates were 9.6% and 13.2%, respectively. No significant differences were found based on perioperative characteristics or additional procedures.
Conclusions:
- Enterocystoplasty in pediatric patients is linked to substantial perioperative morbidity.
- Setting realistic expectations during preoperative counseling is crucial for managing neurogenic bladder.
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.
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