Abstract：
OBJECTIVE:To report trends in surgical approach and associations with outcomes in children undergoing extirpative renal surgery in the state of Maryland over a 12-year period. METHODS:The Maryland Health Services Cost Review Commission (HSCRC) database was queried to identify children undergoing total or partial nephrectomy between 2000 and 2011. Demographic, clinical, hospital, and charge data were compared between children undergoing open and minimally invasive renal surgery. Multivariable logistic regression analysis was performed to identify independent predictors of prolonged length of hospital stay and 30-day readmission. Multivariable linear regression was performed to identify independent predictors of increased hospital charges. RESULTS:Of the 346 children undergoing extirpative renal surgery, 289 (83.5%) underwent total nephrectomy and 48 (13.9%) underwent minimally invasive surgery. Utilization of minimally invasive surgery for congenital urinary anomalies has steadily increased from 15% to 35% over the past decade. Children undergoing minimally invasive total nephrectomy were healthier, had shorter hospital stay, and were more likely to have surgery at a high-volume institution. No such differences were noted in patients undergoing open and minimally invasive partial nephrectomy. On multivariable regression analyses, high patient complexity was the main predictor of increased length of stay (OR 16.02, 95% CI 7.06-36.31), 30-day readmission (OR 3.04, 95% CI 1.38-6.70), and total hospital charge (p < 0.001). CONCLUSION:In Maryland hospitals, most extirpative renal surgeries in children are total nephrectomies performed using an open technique by high-volume surgeons. Although the overall proportion of minimally invasive surgeries has not increased over time, the utilization of MIS in congenital anomaly cases has. Patient complexity and not operative approach dictates postoperative morbidity and hospital charges.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Cohen J,Mullins JK,Jayram G,Patel HD,Pierorazio PM,Matlaga BR,Allaf MEdoi
10.1016/j.jpurol.2013.12.011subject
Has Abstractpub_date
2014-08-01 00:00:00pages
717-23issue
4eissn
1477-5131issn
1873-4898pii
S1477-5131(14)00003-5journal_volume
10pub_type
杂志文章abstract：INTRODUCTION AND OBJECTIVES:Vesicoureteral reflux (VUR) has been one of the defining conditions unique to pediatric urology since its inception. The clinical implications of this disease process depend on intrinsic patient factors such as age, genetics, epigenetics, voiding habits, anatomic anomalies, and extrinsic fac...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2018.04.004
更新日期：2018-10-01 00:00:00
abstract：INTRODUCTION:Videourodynamics is the key follow-up examination of children with myelomeningocele. However, it has been performed in specific institutions focused on the urological management of children due to the difficulty in its interpretation. Although a neurogenic bladder frequently appears elongated vertically an...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2020.09.015
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:Children with valve bladder syndrome represent the worst end of the posterior urethral valve spectrum. When conservative measures fail to control recurrent infections, prevent deterioration of the upper tract (in the form of increasing hydronephrosis and or worsening of kidney function) and improve incontinen...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2007.06.005
更新日期：2007-12-01 00:00:00
abstract：INTRODUCTION:In severe hypospadias, urethral plate division is necessary for curvature correction. To configure the new urethra, an approach has been described using a foreskin flap directly anastomosed in an 'onlay' fashion to the tunica albuginea of the corpora cavernosa. Results suggest that it is possible to use th...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2015.04.027
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Double J (DJ) stents placed at the end of paediatric urological procedures require another cystoscopy under general anaesthesia for removal. The second author developed a reproducible technique for snaring the DJ stent using an infant feeding tube (6-Fr or 8-Fr) and a 3-0 polypropylene suture per urethra. Ha...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpurol.2019.08.009
更新日期：2019-12-01 00:00:00
abstract：OBJECTIVE:To determine the changes in number and morphology of interstitial cells of Cajal (ICC)-like cells (ICC-LC) at the ureteropelvic junction (UPJ) of rats after experimental distal ureteral obstruction. MATERIALS AND METHODS:Of a total of 109 rats, 20 served as controls (C), 20 underwent sham-operations (SH) and...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2008.12.006
更新日期：2009-08-01 00:00:00
abstract：OBJECTIVES:It has been suggested that infants with dilating vesicoureteral reflux (VUR) often have lower urinary tract (LUT) dysfunction. Signs such as high voiding pressure levels, low bladder capacity and dyscoordination at voiding have previously been thought to be indicative of dysfunction. However, these findings ...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2014.08.010
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:Perioperative antibiotics prevent infections after surgery. Guidelines for antibiotic use allow the surgeon to balance the risks of adverse events and drug resistance with the benefit of reduced infection rates. However, due to a lack of evidence-based guidelines within pediatric urology, antibiotic practice...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2020.05.148
更新日期：2020-10-01 00:00:00
abstract：BACKGROUND:The purpose of ureterocystoneostomy to correct vesicoureteral reflux is to thereby prevent recurrent febrile urinary tract infections (UTIs). The objective of this study was to determine the frequency of UTI in adult women who underwent reimplantation as children, with the emphasis on infections during pregn...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2006.09.006
更新日期：2007-06-01 00:00:00
abstract：INTRODUCTION:Preoperative hormonal stimulation (PHS) is commonly administered to improve hypospadias outcomes. However, current literature provides no clear evidence to support its use, and controversies exist regarding its effect on postoperative complications. Herein we systematically evaluate the effect of PHS on po...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpurol.2017.06.019
更新日期：2017-10-01 00:00:00
abstract：PURPOSE:We conducted a cross-sectional study to evaluate whether the different positions during urination influence the electrical activity of the abdominal and perineal musculature, as well as the uroflowmetric parameters of children with lower urinary tract dysfunction (LUTD). MATERIALS AND METHODS:Ninety-four child...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2014.03.013
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV) is a minimally invasive alternative to open surgery. We have previously reported retrospective outcomes from our study group, and herein provide an updated prospective analysis with a focus on success rate, surgical technique, and co...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpurol.2018.01.020
更新日期：2018-06-01 00:00:00
abstract：AIM:To compare complication rates after distal hypospadias surgery using the tubularized incised plate (TIP) and Mathieu techniques. METHODS:For this meta-analysis, the Medline (1990-2009), Embase (1990-2009) and Cochrane databases were searched using the keyword 'hypospadias'. Inclusion criteria were: i) primary repa...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpurol.2010.11.008
更新日期：2012-06-01 00:00:00
abstract：INTRODUCTION:Recent studies have suggested contradictory trends in the incidence of undescended testis (UDT) and hypospadias (HYP), partly because of methodological issues and ascertainment bias. The recently described association of "testicular dysgenesis syndrome" links concomitant UDT and HYP, with decreasing sperm ...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2018.07.003
更新日期：2018-12-01 00:00:00
abstract：INTRODUCTION:Cloacal exstrophy (CE) is the most severe manifestation of the epispadias-exstrophy spectrum. Previous studies have indicated an increased rate of renal anomalies in children with classic bladder exstrophy (CBE). Given the increased severity of the CE defect, it was hypothesized that there would be an even...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2016.04.008
更新日期：2016-08-01 00:00:00
abstract：INTRODUCTION:Redo orchiopexy involves a hazardous dissection inside the inguinal canal (IC) where scar tissue encircles the testicular vessels (TesV), vas deferens (VD), and the testis. OBJECTIVE:The aim was to describe and evaluate a combined preperitoneal and inguinal approach (CPI) through a single cutaneous incisi...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2015.05.035
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:Repair of distal hypospadias is one of the most common pediatric urology procedures in the US. However, the risk of postsurgical complications has been reported primarily from single-institution and tertiary center studies, with short duration of patient follow-up. OBJECTIVE:The aim of the study was to exam...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpurol.2019.06.012
更新日期：2019-10-01 00:00:00
abstract：INTRODUCTION:Robot-assisted laparoscopic pyeloplasty (RALP) has been gaining acceptance among pediatric urologists. Over 300 have been described in the literature, but few studies have evaluated the role of RALP in infants alone. OBJECTIVE:We sought to examine the operative experience and outcomes of RALP in a cohort ...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpurol.2014.11.025
更新日期：2015-06-01 00:00:00
abstract：PURPOSE:We hypothesized that there are practice variations in the use of surgical antibiotics by pediatric urologists in the United States. MATERIALS AND METHODS:A 31-question online survey was distributed to members of the Society of Pediatric Urology. The questionnaire examined physician preferences for surgical ant...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2010.05.001
更新日期：2011-04-01 00:00:00
abstract：UNLABELLED:Classical bladder exstrophy affects 1 in 30 000 live births. Results of surgical treatment from different institutions employing various surgical techniques are not uniform, thus there is a need for a consensus on the best technique for bladder exstrophy repair. Surgical correction in bladder exstrophy would...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,评审
doi：10.1016/j.jpurol.2015.05.030
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:Congenital adrenal hyperplasia (CAH) consists of a group of diseases characterized by an enzyme deficiency, particularly 21-hydroxylase deficiency. The condition may present in the simple virilizing form or in the salt-wasting form, with varying degrees of genital ambiguity. The non-heterosexual orientation ...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,评审
doi：10.1016/j.jpurol.2018.08.004
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:Post-ablation urethral strictures are a rare but devastating complication following transurethral ablation of posterior urethral valve which can be more difficult to treat than the valve itself. Though with the miniaturization of scopes the incidence of these strictures has decreased, sadly they still contin...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2020.09.001
更新日期：2020-12-01 00:00:00
abstract：INTRODUCTION:Inflammatory myofibroblastic tumours of the bladder (IMTB) are rare, and feature a benign and reactive proliferation of myofibroblasts. 25% of the reported IMTB cases in the literature occur in children. The present study presents a review of IMTB in children. DISCUSSION:The data from 42 reported cases of...
journal_title：Journal of pediatric urology
pub_type： 杂志文章,评审
doi：10.1016/j.jpurol.2015.03.009
更新日期：2015-10-01 00:00:00
abstract：INTRODUCTION:Upper tract damage (UTD) is a life-threatening complication of neurogenic bladder (NB). Early identification of risk factors for UTD and institution of remedial measures may probably prevent UTD. The aim was to study the predictors of UTD in children 2 years or older with NB. METHOD:This cross-sectional, ...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2017.02.026
更新日期：2017-10-01 00:00:00
abstract：OBJECTIVE:Faecal incontinence secondary to myelomeningocele, Hirschsprung disease, and anorectal anomalies remains a significant and common problem. We aimed to report our 5-year experience with the Peristeen trans-anal irrigation system (TAIS) to manage such children. PATIENTS AND METHOD:This study was a combination ...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2013.08.006
更新日期：2014-04-01 00:00:00
abstract：INTRODUCTION:Parents making complex decisions about hypospadias surgery may experience anxiety and uncertainty related to multiple sources of information with questionable reliability and limited relevance to their concerns. OBJECTIVE:The purpose of this study was to identify knowledge gaps, information-seeking behavi...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2020.01.008
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:We present our experience of management of high-grade renal trauma in a pediatric population, including assessment of the long-term function and morphology of the ipsilateral kidney. PATIENTS AND METHODS:From 1997 to 2005, 40 children with high-grade renal injury (III, IV, V) after blunt abdominal trauma wer...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2006.07.006
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To investigate patterns of care for testicular torsion and influence of hospital transfers on testicular outcomes. Hospital transfer may be a source of treatment delay in a condition where delays increase likelihood of orchiectomy. METHODS:We used a retrospective cohort of Californian males with ICD-9/CPT-de...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2013.06.003
更新日期：2013-12-01 00:00:00
abstract：BACKGROUND:Neutrophil gelatinase-associated lipocalin (NGAL) is a marker of acute kidney injury, and has been shown to be a sensitive marker of renal damage in urinary tract obstruction. Children with neurogenic bladders are at risk of renal damage as a result of increased pressure within the urinary system. A marker o...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2018.12.008
更新日期：2019-04-01 00:00:00
abstract：INTRODUCTION:Many theories have been proposed for the coexistence of constipation and lower urinary tract dysfunction (LUTD), such as bladder compression from a distended rectum and stimulation of sacral reflexes from a full rectum. In these cases, successful treatment of constipation should result in resolution of bla...
journal_title：Journal of pediatric urology
pub_type： 杂志文章
doi：10.1016/j.jpurol.2015.05.032
更新日期：2015-12-01 00:00:00
