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11–14 APRIL, 2018, HELSINKI, FINLAND
08:55–08:58
S14-2 (PP)
ROBOTIC PYELOPLASTY IN CHILDREN AND ADULTS:
ASSESSMENT OF COMPLICATIONS
Kristian FOG-POULSEN and L. Henning OLSEN
Aarhus University Hospital, Skejby, Department of Urology, Aarhus N, DENMARK
PURPOSE
When surgical reconstruction for UPJO is indicated, access can be gained either by the transperi-
toneal or the retroperitoneal approach. No study has shown significant differences in complication
rates between transperitoneal (TA) and retroperitoneal (RA) pyeloplasty and the choice of route
depends on the surgeon's preferences. We assessed the complication rates in children (RA) and
adults (TA) to contribute to the discussion about which route to take.
MATERIAL AND METHODS
Data were obtained from UroLap, a Danish nationwide quality assessment database. Data were
analysed from 2009 and to 2014 after introduction of the Clavien-Dindo classification. Operative
data were sampled prospectively, while incidence of complications was obtained by chart review
retrospectively. In this period a total of 93 children (3–16 years) were admitted for robotic RA pyelo-
plasty and 113 adults (>16 years) for robotic TA pyeloplasty.
RESULTS
Conversion rates to open surgery were 3,5 % in adults and 4,3 % in children. A total of 89 RA
pyeloplasties in children and 109 TA pyeloplasties in adults were completed as robotic-assisted
laparoscopic procedures. Mean operative time was 137 minutes in children and 103 minutes in
adults. Length of hospitalization was 1.9 days in children and 1.6 days in adults. Overall complica-
tion rate (Clavien-Dindo) was 16,9 % in children and 24,8 % in adults. Grade 1 occured in 8,9 %
in children and in 8,6 % of adults. Grade 2 occurred in 3,4 % of children and in 10,1 % of adults.
Grade 3 was reported in 4,5 % of children and 6,4 % of adults. Urinary leakage was seen in five
adult patients. No grade 4 or 5 complications were reported.
CONCLUSIONS
This series of robotic retroperitoneal pyeoloplasty in children is the largest to our knowledge and
contribute to a more valid estimate of the true complication rate of robotic-assited retroperitoneal
pyeloplasty in the paediatric population. No clinically significant urinary leakage occurred in children,
which strengthens the hypothesis of a closer anastomosis sealing after disinflation of the retroperi-
toneal space.