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A Comparison of Open vs Laparoscopic Pediatric Pyeloplasty Using the Pediatric Health Information System Database—Do Benefits of Laparoscopic Approach Recede at Younger Ages?

2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2008.06.044

1527-3792

Stacy T. Tanaka, John A. Grantham, John C. Thomas, Mark C. Adams, John W. Brock, John C. Pope,

Kidney Stones and Urolithiasis Treatments

No AccessJournal of UrologyPediatric Urology1 Oct 2008A Comparison of Open vs Laparoscopic Pediatric Pyeloplasty Using the Pediatric Health Information System Database—Do Benefits of Laparoscopic Approach Recede at Younger Ages?is accompanied byThe Importance of Obtaining Conjugate Views on Renographic Evaluation of Large Hydronephrotic Kidneys: An In Vitro and Ex Vivo Analysis Stacy T. Tanaka, John A. Grantham, John C. Thomas, Mark C. Adams, John W. Brock, and John C. Pope Stacy T. TanakaStacy T. Tanaka , John A. GranthamJohn A. Grantham , John C. ThomasJohn C. Thomas , Mark C. AdamsMark C. Adams , John W. BrockJohn W. Brock , and John C. PopeJohn C. Pope View All Author Informationhttps://doi.org/10.1016/j.juro.2008.06.044AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The potential benefits of laparoscopic pyeloplasty may recede in younger age groups. We used a multi-institutional database to address the effect of laparoscopic approach on length of stay and postoperative parenteral narcotic use in specific pediatric age groups. Materials and Methods: We performed a retrospective study of 5,261 children with an ICD-9 procedure code for correction of ureteropelvic junction obstruction from the Pediatric Health Information System, a database of freestanding pediatric hospitals. Discharge dates from January 1, 2002 to June 30, 2007 were included. Laparoscopic cases were identified by ICD-9 procedure codes and hospital equipment charges. We used multivariate linear regression to investigate the effect of laparoscopic approach on length of stay and parenteral narcotic use in several age categories, including infant (1 month to less than 2 years old), preschool (2 to less than 6 years), grade school (6 to less than 10 years), preadolescent (10 to less than 13 years) and adolescent (13 to less than 19 years). Results: Laparoscopic approach decreased length of stay and number of parenteral narcotic pharmacy charges in the preadolescent (p = 0.03 and p = 0.005, respectively) and adolescent (p = 0.03 and p = 0.006, respectively) groups but not in any of the younger groups. Conclusions: Laparoscopic approach was associated with a shorter hospital stay and decreased parenteral narcotic use in patients older than 10 years. Evolving technique may reveal less morbidity in younger patients. Future comparisons to open pyeloplasty should address specific pediatric age groups and outpatient convalescence. References 1 : Pediatric laparoscopic dismembered pyeloplasty. J Urol1995; 153: 1962. Link, Google Scholar 2 : Laparoscopic transabdominal pyeloplasty in children is feasible irrespective of age. J Urol2006; 175: 688. Link, Google Scholar 3 : Laparoscopic pyeloplasty in the infant younger than 6 months—is it technically possible?. J Urol2006; 175: 1477. 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Google Scholar Division of Pediatric Urology, Monroe Carell Jr. Vanderbilt Children's Hospital, Nashville, Tennessee© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByRague J, Arora H, Chu D, Shannon R, Rosoklija I, Johnson E, Gong E and Lindgren B (2021) Safety and Efficacy of Robot-Assisted Laparoscopic Pyeloplasty Compared to Open Repair in Infants under 1 Year of AgeJournal of Urology, VOL. 207, NO. 2, (432-440), Online publication date: 1-Feb-2022.Ghidini F, Bortot G, Gnech M, Contini G, Escolino M, Esposito C, Capozza N, Berrettini A, Masieri L and Castagnetti M (2021) Comparison of Cosmetic Results in Children >10 Years Old Undergoing Open, Laparoscopic or Robotic-Assisted Pyeloplasty: A Multicentric StudyJournal of Urology, VOL. 207, NO. 5, (1118-1126), Online publication date: 1-May-2022.Varda B, Johnson E, Clark C, Chung B, Nelson C and Chang S (2013) National Trends of Perioperative Outcomes and Costs for Open, Laparoscopic and Robotic Pediatric PyeloplastyJournal of Urology, VOL. 191, NO. 4, (1090-1096), Online publication date: 1-Apr-2014.Turner R, Fox J, Tomaszewski J, Schneck F, Docimo S and Ost M (2012) Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction in InfantsJournal of Urology, VOL. 189, NO. 4, (1503-1507), Online publication date: 1-Apr-2013.Sukumar S, Sun M, Karakiewicz P, Friedman A, Chun F, Sammon J, Ghani K, Ravi P, Bianchi M, Jeong W, Shariat S, Hansen J, Peabody J, Elder J, Menon M and Trinh Q (2012) National Trends and Disparities in the Use of Minimally Invasive Adult PyeloplastyJournal of Urology, VOL. 188, NO. 3, (913-918), Online publication date: 1-Sep-2012.Gargollo P (2011) Hidden Incision Endoscopic Surgery: Description of Technique, Parental Satisfaction and ApplicationsJournal of Urology, VOL. 185, NO. 4, (1425-1431), Online publication date: 1-Apr-2011.Braga L, Lorenzo A, Bägli D, Mahdi M, Salle J, Khoury A and Farhat W (2009) Comparison of Flank, Dorsal Lumbotomy and Laparoscopic Approaches for Dismembered Pyeloplasty in Children Older Than 3 Years With Ureteropelvic Junction ObstructionJournal of Urology, VOL. 183, NO. 1, (306-311), Online publication date: 1-Jan-2010.Kajbafzadeh A, Tourchi A, Bazargani S and Nezami B (2010) Single Incision Miniature Pyeloplasty and Ipsilateral Inguinal Herniorrhaphy in InfantsJournal of Urology, VOL. 183, NO. 4, (1545-1550), Online publication date: 1-Apr-2010.Coplen D (2009) Do We Need More Rigorous Standards for Validation of New Technology?Journal of Urology, VOL. 182, NO. 5, (2107-2108), Online publication date: 1-Nov-2009.Related articlesJournal of Urology19 Aug 2008The Importance of Obtaining Conjugate Views on Renographic Evaluation of Large Hydronephrotic Kidneys: An In Vitro and Ex Vivo Analysis Volume 180Issue 4October 2008Page: 1479-1485 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordspostoperativeureteral obstructionlaparoscopypainlength of staypediatricsMetricsAuthor Information Stacy T. 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