MP44-12 STENTLESS ROBOTIC PYELOPLASTY: LESS OPERATIVE TIME AND NO INCREASE IN COMPLICATIONS

Abstract

You have accessJournal of UrologyPediatric Urology II (MP44)1 Sep 2021MP44-12 STENTLESS ROBOTIC PYELOPLASTY: LESS OPERATIVE TIME AND NO INCREASE IN COMPLICATIONS Campbell Grant, William DeFoor, Michael Daugherty, Andrew Strine, Pramod Reddy, and Paul Noh Campbell GrantCampbell Grant More articles by this author , William DeFoorWilliam DeFoor More articles by this author , Michael DaughertyMichael Daugherty More articles by this author , Andrew StrineAndrew Strine More articles by this author , Pramod ReddyPramod Reddy More articles by this author , and Paul NohPaul Noh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002065.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Children undergoing robotic pyeloplasty (RP) for ureteropelvic junction obstruction often have internal double J ureteral stents placed at the time of surgery to facilitate drainage and prevent complications. However, placement of a stent typically requires a second anesthetic for removal. Previous studies have shown that stentless pyeloplasties are a feasible option, but none have compared outcomes to stented patients. The goal of this study is to assess overall complication rates between stented and stentless pyeloplasties at a single institution. METHODS: A prospective cohort study was performed of all robotic pyeloplasties performed by four surgeons in our institution from 2015 to 2020. A historical cohort of stented pyeloplasties from 2009 to 2020 was used as a control group. Categorical variables were analyzed using a chi-square test and continuous variables were compared using a two-sided t-test. RESULTS: A total of 310 patients underwent RP and met inclusion criteria. 114 patients in the study group underwent pyeloplasty without a ureteral stent and 196 control patients had a stent placed at the time of surgery. Stentless patients were younger (median: 19 vs. 75 months, p<0.001) and weighed less (11 vs. 23 kg, p<0.001) than stented patients. The average operative time for stentless patients (192 minutes) was less than stented patients (211 minutes, p=0.002). The overall complication rate in the stentless group (7%) was comparable to the stented group (10%), although there was a higher incidence of Clavien level 3/4 complications in the stentless group (5.3% vs. 2%). One infant boy with worsening hydronephrosis developed urosepsis requiring a PICU admission 4 weeks post-operatively and underwent urgent stent placement. There was one confirmed urinary leak and two suspected urinary leaks due to abdominal distension and ileus that were treated with a ureteral stent. One concomitant unrecognized ureterovesical junction obstruction required a percutaneous nephrostomy. CONCLUSIONS: Stentless robotic pyeloplasty appears to be comparable to stented pyeloplasties from a safety and clinical outcomes standpoint with the benefits of a shorter operative time and the avoidance of a second procedure. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e797-e797 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Campbell Grant More articles by this author William DeFoor More articles by this author Michael Daugherty More articles by this author Andrew Strine More articles by this author Pramod Reddy More articles by this author Paul Noh More articles by this author Expand All Advertisement Loading ...