Urology Department, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, 1245 Buenos Aires, Argentina.
To retrospectively assess early postoperative complications in augmentation cystoplasty without preoperative mechanical bowel preparation (MBP).
Between May 1987 and May 2006, 162 cystoplasties were performed in 158 children. The segments used were: sigmoid colon (81.5%), ileum (13%), and ileocecum (5.5%). The mean age was 8.65 years (range 2.1-22.7 years). No preoperative MBP of any kind was used in any of the patients and all of them received antibiotics preoperatively and postoperatively.
No intraoperative complications related to the procedure were reported. The mean hospital stay was 9.48 days (range 4-30 days). The mean time to intake of oral fluids was 94.77h (range 48-288h). Postoperative complications occurred in 9.87%: urinary fistula was the most common (2.4%); only 3 patients presented wound infection (1.85%); 5 patients required reoperative surgery (hemoperitoneum, patch necrosis and 3 cases of urinary peritonitis); 1 patient presented an intra-abdominal abscess that resolved with antibiotic treatment.
Preoperative MBP can be omitted in children that require augmentation cystoplasty without an increased risk of infectious or anastomotic complications. Further prospective, randomized clinical trials should be carried out in order to validate our findings in the pediatric population.
Written by:
Víctor D, Burek C, Corbetta JP, Sentagne A, Sager C, Weller S, Paz E, Bortagaray JI, Lopez JC. Are you the author?
Reference: J Pediatr Urol. 2011 Aug 8. Epub ahead of print.
doi: 10.1016/j.jpurol.2011.01.015
PubMed Abstract
PMID: 21831716
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