PD15-11 COMPREHENSIVE REVIEW OF A LARGE COHORT OF OUTPATIENT VERSUS INPATIENT OPEN RENAL AND BLADDER SURGERY IN CHILDREN

Abstract

You have accessJournal of UrologyPediatric Urology I (PD15)1 Sep 2021PD15-11 COMPREHENSIVE REVIEW OF A LARGE COHORT OF OUTPATIENT VERSUS INPATIENT OPEN RENAL AND BLADDER SURGERY IN CHILDREN Winston Crute, Andrew Wofford, Jackson Powers, and Dean Preston Smith Winston CruteWinston Crute More articles by this author , Andrew WoffordAndrew Wofford More articles by this author , Jackson PowersJackson Powers More articles by this author , and Dean Preston SmithDean Preston Smith More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001997.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Major urologic surgery for pediatric patients is being performed more frequently in an outpatient setting. Ambulatory surgery centers are being utilized to perform these surgeries safely, efficiently, and with significantly lower costs. Our study sets out to compare outcomes of open renal and bladder surgery in the outpatient versus the inpatient setting. METHODS: IRB-approved chart review was performed of patients undergoing nephrectomies, ureteral reimplantations, complex ureteral reimpantations and pyeloplasties by a single pediatric urologist between January 2003 and March 2020. All procedures were performed at a freestanding pediatric surgery center (PSC) and a children’s hospital (CH). Comprehensive review of demographics, type of procedures, American Society of Anesthesiologists (ASA) score, operative times, ancillary procedures, time to discharge, readmission or ER visits within 72 hours of discharge, and catheter and/or stent use. Patient home’s zip codes were used to determine approximate distance from PSC and CH. RESULTS: A total of 982 open renal and bladder procedures (85 nephrectomies, 507 ureteral reimplants, 179 complex ureteral reimplants with tapering/ureterocelectomy/ureteroureterostomy, and 211 pyeloplasties) and of these 919 (94%) procedures were performed as an outpatient: 729 at the PSC (3 inpatients) and 190 at the CH (63 inpatients) and 388 patients (39.5%) underwent simultaneous ancillary procedures. Mean patient age was 4.6±4.32 years, 646 patients were female, and 336 were male. Outpatients had a significantly lower age, lower ASA score, operative time, and readmission or return to ER with 72 hours (1.5% vs 5.9%). There were no differences in gender, time to discharge, catheter/stent use, or facility distance from home. There was no significant difference in readmission/ER visit rates based on PSC vs CH location. Based on home zip codes, PSC patients lived significantly farther away than patients operated at CH (66.7±49.1 miles vs. 53.3±46.7, p<0.001). CONCLUSIONS: Pediatric nephrectomies, ureteral reimplantations, complex ureteral reimplantations, and pyeloplasties can be safely performed in an outpatient setting as well as at freestanding surgery centers. Our data suggests that younger, healthier children have a lower chance to return to the hospital or emergency room after undergoing complex open renal and bladder surgery in an outpatient setting. Our findings suggest that in addition to reduced costs and burden on families, outpatient open renal and bladder surgery provide an excellent alternative to hospitalized contemporary techniques. Source of Funding: © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e277-e277 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Winston Crute More articles by this author Andrew Wofford More articles by this author Jackson Powers More articles by this author Dean Preston Smith More articles by this author Expand All Advertisement Loading ...