1202 FACTORIAL ANALYSIS OF PARENTAL PREFERENCE IN OPEN COMPARED TO LAPAROSCOPIC SURGICAL INCISIONAL SCARS

Abstract

You have accessJournal of UrologyPediatrics: Reconstructive Surgery - Diversion, Endourology & Transplantation, Trauma1 Apr 20121202 FACTORIAL ANALYSIS OF PARENTAL PREFERENCE IN OPEN COMPARED TO LAPAROSCOPIC SURGICAL INCISIONAL SCARS Joao Barbosa, Ghassan Barayan, Alan Retik, and Hiep Nguyen Joao BarbosaJoao Barbosa Sao Paulo, Brazil More articles by this author , Ghassan BarayanGhassan Barayan Boston, MA More articles by this author , Alan RetikAlan Retik Boston, MA More articles by this author , and Hiep NguyenHiep Nguyen Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1469AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic surgery is reported to result in smaller scars than open surgery. Even though this fact is often assumed as a cosmetic advantage, the extent to which it improves patient satisfaction and influences decision-making is rarely studied. Such reports are even less frequent in the pediatric population, whose peculiarities in tissue repair and body image would advocate specific investigation. Furthermore, demographic predictors for preference of surgery and satisfaction with scar are unknown in pediatric patients. The objective of this study is to evaluate patient and parental preference for open vs. laparoscopic scars preoperatively. METHODS Three surgery-specific surveys (for pyeloplasty, ureteral reimplantation and bladder augmentation) were developed for preoperative assessment of preference and perception of scars. The surveys consisted of a demographic questionnaire and a section on preference for scars composed of diagrams and pictures of long-term postoperative results of open and robotic-assisted laparoscopic surgery. Questionnaires were given to parents of children diagnosed with a condition that might require the surgery in question in a future time. RESULTS Fifty-five parents completed the survey (26 pyeloplasty, 25 ureteral reimplant, and 4 bladder augmentation). Laparoscopic scars were preferred in all three types of surgery, by 77.7 % of parents for pyeloplasty, 81.8 % for reimplant and all parents for augmentation (p<0.05). Even though a higher percentage of parents would opt for laparoscopic surgery if the risks and outcomes were assumed to be the same as in open surgery, the vast majority (88.6%) would choose the type of surgery that offered better clinical outcomes. Parents seemed to base their choice on size and visibility of the scar more than on location and possibility of covering the scar with clothing (p<0.05). Parent or patient age, gender, household income or level of education were not independent predictors for parental preference of surgery. CONCLUSIONS Laparoscopic scars were preferred by parents over open surgery scars, with a majority of parents opting for laparoscopic surgery only if assuming equivalent risks and benefits for the two techniques. Consequently, parental preference of surgery relies more on clinical outcomes than on perception of scars. In counseling parents regarding the various options for urological surgery, not only it is important to indicate the scar location but more importantly the clinical success of each of different modality. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e486-e487 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joao Barbosa Sao Paulo, Brazil More articles by this author Ghassan Barayan Boston, MA More articles by this author Alan Retik Boston, MA More articles by this author Hiep Nguyen Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...