Predictive factors for early discharge (≤24 hours) and re-admission following robotic-assisted laparoscopic pyeloplasty in children
Keywords:Uteropelvic junction obstruction, Pyeloplasty, Robotic, Discharge
Introduction: Minimally invasive pyeloplasty (MIP) for correction of ureteropelvic junction (UPJ) obstruction in children has significantly improved the postoperative management of these patients. In this study, we sought to examine the factors associated with early discharge (≤24 hours) in children that underwent robotic-assisted laparoscopic pyeloplasty (RALP).
Methods: We performed a retrospective chart review of all children who underwent RALP from 2012 to 2018 in our center. Descriptive statistics and a non-adjusted risk analysis were performed to evaluate the factors associated with early discharge (≤24h), readmission, and complications within the first 30 days after the procedure.
Results: Eighty-nine patients out of 124 total pyeloplasties (72%) stayed ≤24 hours post-surgery. Of the variables analyzed, later cases were statistically associated with length of stay (LOS); the first 55 patients had a lower probability of being hospitalized for ≤24 hours (odds ratio [OR] 0.24, 95% confidence interval [CI] 0.09–0.64, p=0.004).
Conclusions: Robotic-assisted pyeloplasty for children is associated with a high rate of early recovery, short hospital stay, low re-admission, and complication rate. Although not statistically significant, patients with shorter operative room time also had a shorter LOS. An increased LOS was observed in the initial patients of our series, and this is most likely explained because of the initial learning curve of all the team for the procedure itself and the more conservative postoperative management.
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