Enterocystoplasty 30-day outcomes from National Surgical Quality Improvement Program Pediatric 2012

J Pediatr Surg. 2015 Sep;50(9):1535-9. doi: 10.1016/j.jpedsurg.2015.04.009. Epub 2015 Apr 25.

Abstract

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.

Keywords: Bladder augmentation; Enterocystoplasty; NSQIP pediatric; Neurogenic bladder; Perioperative complications.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Intestines / transplantation*
  • Length of Stay / statistics & numerical data
  • Male
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Quality Improvement*
  • Reoperation / statistics & numerical data
  • Treatment Outcome
  • United States
  • Urinary Bladder / surgery*
  • Urinary Bladder, Neurogenic / surgery*
  • Urologic Surgical Procedures*