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Factors Associated With Short Term Outcomes After Pyeloplasty in the Pediatric Population

Olamide Olawoyin1, Benjamin Press1, Ankur Choksi1

  • 1Department of Urology, Yale New Haven Hospital, New Haven, CT.

Urology
|February 19, 2025
PubMed

Insights

Complications after pediatric pyeloplasty are rare, with urinary tract infections being most common. History of prematurity and low weight increase complication risk in pediatric pyeloplasty patients.

Area of Science:

  • Pediatric Urology
  • Surgical Outcomes Research
  • Health Informatics

Background:

  • Pyeloplasty is a common procedure for pediatric ureteropelvic junction obstruction.
  • Understanding factors influencing post-operative outcomes is crucial for improving patient care.
  • The National Surgical Quality Improvement Program Pediatrics (NSQIP-P) database offers valuable insights into surgical outcomes.

Purpose of the Study:

  • To identify patient and surgical factors associated with 30-day morbidity following pediatric pyeloplasty.
  • To analyze complication rates and types after open and laparoscopic pyeloplasty.
  • To stratify risks based on patient demographics and surgical characteristics.

Main Methods:

  • Retrospective cohort study utilizing the NSQIP-P database (2012-2021).
  • Inclusion of pediatric patients undergoing open or laparoscopic pyeloplasty.
  • Evaluation of patient factors (age, prematurity, weight, ASA classification) and surgical factors (operative time, pre-op labs, steroid use).
  • Complication assessment using Clavien-Dindo (CD) classification.

Main Results:

  • 8221 patients were analyzed; 6.4% experienced 30-day readmissions.
  • Urinary Tract Infection (UTI) was the most frequent complication (2.8%).
  • History of prematurity (HOP) and younger age (<23 months) correlated with Clavien-Dindo I-II complications.
  • Low weight was associated with higher-grade complications (CD III-V).
  • HOP significantly increased UTI incidence (OR 8.09).

Conclusions:

  • Post-pyeloplasty complications are infrequent, with UTIs being the primary concern.
  • History of prematurity and low weight at surgery are significant risk factors for pyeloplasty complications.
  • Risk stratification incorporating these factors can aid in optimizing surgical planning and patient management.
Abstract

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