ESPU Congress 2017 - Abstract book

159

19–22 APRIL, 2017, BARCELONA, SPAIN

10:30–10:35

S15-2 (LO)

PREDICTORS OF HIGH-GRADE COMPLICATIONS

IN PEDIATRIC ROBOT-ASSISTED UROLOGIC SURGERY

ON THE UPPER URINARY TRACT

Nimrod BARASHI

, William BOYSEN

, Eric SCHADLER

, Vignesh PACKIAM

and Mohan S. GUNDETI

1) The University of Chicago, Section of Urology, Chicago, USA - 2) The University of Chicago, Pritzker School

of Medicine, Chicago, USA

INTRODUCTION

The use of robot-assisted laparoscopic (RAL) surgery in pediatric urology has increased in recent

years. We sought to analyze our institutional experience with RAL surgery on the upper urinary tract

to identify the incidence of grade III or higher Clavien-Dindo complications, and assess for factors

associated with complications.

PATIENTS AND METHODS

We retrospectively reviewed our single-surgeon experience performing RAL surgery on the upper

urinary tract in children from 2007 to 2016. Complications were graded on the Clavien-Dindo scale

and a univariate analysis was performed.

RESULTS

We identified 137 patients who underwent RAL upper tract surgery, with a median follow up of

11 months (IQR 4-23.5) and a mean age of 6.3 years (SD 5.9). The type and distribution of proce-

dures is shown in Table 1. Of all the patients, 6 had grade III complications (4.38%) and there were

no grade IV or V complications, as well as no complications related to access. The most common

type of complication was urinary (2.19%), then wound-related (1.46%) and lastly gastrointestinal

(0.73%). On univariate analysis, age less than 1 year, BMI, and EBL were not associated with in-

creased odds of grade III complications (p>0.05), but longer operative time was (OR 1.01, p=0.04).

Table 1: Procedure type and distribution

Total patients (n)

Pyeloplasty, n (%)

Heminephrectomy, n (%)

Pyelolithotomy, n (%)

Ureterocalicostomy, n (%)

Nephrectomy, n (%)

Nephropexy, n (%)

137

102 (74.45)

25 (18.25)

6 (4.38)

2 (1.46)

1 (0.73)

CONCLUSIONS

This large single-surgeon series demonstrates that RAL pediatric surgery is a safe approach for

upper urinary tract procedures, with no complications related to access and low incidence of major

complications on long-term follow up. On univariate analysis, operating time was associated with

increased odds of complication, which likely reflects the case complexity in a series performed by

a highly experienced robotic surgeon.