Abstract：
BACKGROUND/PURPOSE:Payers have established unplanned returns as quality measures tied to reimbursement. We sought to identify patient characteristics and surgical factors associated with unplanned returns and postoperative complications following intraabdominal pediatric urologic procedures. Only one study has emergency room visits in pediatric urology, but included only limited case complexity. METHODS:We retrospectively reviewed electronic medical records of all pediatric patients who underwent urological surgery from 2007 to 2016 by a single surgeon. Univariate and multivariate regressions were used to determine factors associated with length of stay, unplanned ER visits and readmissions. RESULTS:A total of 372 cases were included, of which 251 were robotic and 121 were open. Overall, the rate of ER visits was 19%, rate of readmissions was 8.7%, and rate of reoperations was 4.3%. We found that the odds of a urologic ER visit and Clavien grade II (infectious) complications were comparatively lower for robotic surgery, but not readmission. Undergoing a lower tract procedure was significantly associated with a related ER visit; however, patient insurance status was not related to unplanned returns. CONCLUSIONS:Procedure characteristics, not patient demographics were associated with unplanned returns. Robotic approach was associated with fewer ER visits and infectious complications, indicating potential cost savings. LEVELS OF EVIDENCE:Level 3 Treatment Study.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Wallace A,Rodriguez MV,Gundeti MSdoi
10.1016/j.jpedsurg.2018.12.004subject
Has Abstractpub_date
2019-10-01 00:00:00pages
2120-2124issue
10eissn
0022-3468issn
1531-5037pii
S0022-3468(18)30813-3journal_volume
54pub_type
杂志文章abstract：:The effect of whole bowel irrigation (WBI) with a polyethylene glycol electrolyte lavage solution (PEG-ELS; 27 children) was compared to the WBI with two electrolytic solutions: normal saline with added potassium chloride (NS; 25 children) and Ringer's injection (RI; 29 children). The PEG-ELS required less volume and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80423-8
更新日期：1988-08-01 00:00:00
abstract：:Although microtia occurs in only 1:7000 to 8000 births, this major congenital ear deformity can result in significant psychological trauma for the affected child. Reconstruction of this complex deformity represents one of the greatest challenges to the reconstructive surgeon. Based on the pioneering work of Tanzer and...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80271-7
更新日期：1984-08-01 00:00:00
abstract：BACKGROUND:Rhomboid excision with Limberg flap (RELF) repair has been shown to be effective in the management of pilonidal disease (PD) in adults. Wide excision allows complete removal of diseased tissue, and the rotational flap allows tensionless coverage as well as helps flatten the natal crease, which is believed to...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.11.033
更新日期：2009-08-01 00:00:00
abstract：:The rapid spread of coronavirus disease 2019 (COVID-19) has exceeded the standard capacity of many hospital systems and led to an unprecedented scarcity of resources, including the already limited resource of extracorporeal membrane oxygenation (ECMO). With the large amount of critically ill patients and the highly co...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2020.08.015
更新日期：2020-12-01 00:00:00
abstract：:A rare case of duodenal duplication cyst containing stones in a 17-year-old patient is presented. The cyst, acting as a leading point for duodeno-jejunal intussusception caused proximal small bowel obstruction and hyperbilirubinemia. Preoperative diagnosis was based on abdominal computerized tomography. At operation, ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(99)90176-8
更新日期：1999-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:The aim of this study was to determine if the presence of "blush" (an indication of active bleeding) on abdominal CT in children with blunt liver injury adversely affected their clinical outcome as has been reported in adults. METHODS:The authors reviewed the records of 105 children ages 1 to 16 yea...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1053/jpsu.2003.50109
更新日期：2003-03-01 00:00:00
abstract：:Vascular anomalies are an uncommon cause of gastrointestinal bleeding in childhood. Confusing nomenclature has made objective comparisons of published cases difficult and has interfered with an established consensus regarding diagnosis and therapeutic modalities. The purpose of this study was to clarify the situation ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90640-0
更新日期：1997-06-01 00:00:00
abstract：BACKGROUND/PURPOSE:Previous reports of laparoscopic repair of Morgagni hernias in children have involved relatively complex laparoscopic techniques. This report describes a simpler method of repair that we have applied to 4 children. METHODS:Four children with retrosternal (Morgagni) hernias underwent primary laparosc...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/jpsu.2003.50163
更新日期：2003-05-01 00:00:00
abstract：:Congenital stenosis involving the entire length of the trachea has generally been regarded as a fatal disease. Tracheoplasty using costal cartilage grafts to enlarge the lumen was successfully employed in such a case, and the technique is described. A 12-mo-old female was referred with recurrent severe respiratory dis...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(82)80458-2
更新日期：1982-12-01 00:00:00
abstract：:Bacterial translocation is the passage of viable bacteria from the lumen of the gastrointestinal tract through the intestinal mucosa to other sites. It is believed that bacterial translocation may lead to infection and septicemia. The purpose of this study was to determine what factors in experimental surgical trauma ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90368-h
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Guidelines for evaluating the cervical spine in pediatric trauma patients recommend cervical spine CT (CSCT) when plain radiographs suggest an injury. Our objective was to compare usage of CSCT between a pediatric trauma center (PTC) and referral general emergency departments (GEDs). METHODS:Patient data fr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2013.10.006
更新日期：2014-02-01 00:00:00
abstract：:Tracheal agenesis is a rare and usually lethal congenital malformation of the forgut. Although some infants can be resuscitated with an intra-esophageal intubation temporarily, long-term airway management is difficult because of the collapsing airway. We report a long-term survivor with tracheal agenesis in whom a Gor...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.06.013
更新日期：2008-10-01 00:00:00
abstract：BACKGROUND/PURPOSE:Permanent hyperinsulinemic hypoglycaemia in infancy (PHHI)I is a severe disease that leads to brain damage. Since 1989, pathologists have identified 2 different forms of the disease: a diffuse form (DiPHHI) and a focal form (FoPHHI). The purpose of this study was to adapt surgical techniques in case ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2002.30241
更新日期：2002-02-01 00:00:00
abstract：PURPOSE:Implementation of a nonaccidental trauma (NAT) screening guideline for the evaluation of infants admitted with an unwitnessed head injury has eliminated screening disparities. This study sought to determine the overall NAT rate and key predictive factors using this guideline. METHODS:All infants screened via t...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.02.014
更新日期：2017-11-01 00:00:00
abstract：PURPOSE:The aim of the study was to report the experience with renal cell carcinoma (RCC) in children. MATERIALS AND METHODS:We conducted a retrospective study on renal adenocarcinoma cases treated in our center between 1993 and 2008. The age limit was established at 15 years. We collected data on personal history, di...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.02.073
更新日期：2009-09-01 00:00:00
abstract：:Esophageal achalasia (EA) has been historically treated by esophageal dilatation or myotomy with or without fundoplication. Botulinum toxin (Botox-Allergan) use in pediatric EA has not been previously described. The authors' objective was to observe the efficacy of botulinum toxin injection into the lower esophageal s...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90650-3
更新日期：1997-06-01 00:00:00
abstract：BACKGROUND/PURPOSE:Adnexal torsion is a serious condition that frequently may result in ovarian removal, and there always is a risk of castration if the contralateral ovary undergo torsion as well. In this study, the authors present their experience with adnexal torsion in 15 children and describe a catastrophic event,...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1053/jpsu.2002.36195
更新日期：2002-11-01 00:00:00
abstract：:The management of a large proboscoid umbilical hernia presents challenging problems to the surgeon. As children and parents are concerned with the appearance of the actual hernia they are also intensely interested in the postsurgical result. Presented is a simple one-stage umbilicoplasty that allows repair of the fasc...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(87)80587-0
更新日期：1987-10-01 00:00:00
abstract：BACKGROUND:Minimally invasive pyeloplasty is a difficult procedure even for an expert laparoscopic surgeon. The major difficulty is associated with the limitations of intracorporeal suturing and knot tying. Surgical robots, which hold minimally invasive surgical instruments, have wrists and provide tremor filtration an...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.10.029
更新日期：2005-02-01 00:00:00
abstract：BACKGROUND:Scintigraphy is considered the "gold standard" for investigating gastric emptying. The lack of standards regarding registration technique and meal composition has been a problem especially in pediatric patients. METHODS:In this study, gastric emptying of a solid meal was assessed by scintigraphy in 10 patie...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90091-4
更新日期：1998-03-01 00:00:00
abstract：:Seventeen pediatric patients with a major salivary gland malignancy (16 parotid, 1 submaxillary) were reviewed. Eight patients presented with carcinoma. The usual presentation was a mass over the affected gland. Six patients had localized disease, which was treated by excision. This was accomplished by either a total ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(94)90520-7
更新日期：1994-01-01 00:00:00
abstract：BACKGROUND/PURPOSE:Biliary decompression for congenital or acquired obstruction (eg, biliary atresia) does not uniformly lead to liver repair, restore function, or prevent cholangitis. The authors hypothesize that failed repair is caused by altered macrophage (Mo) phenotypes central to an ongoing inflammatory and fibro...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.20059
更新日期：2001-01-01 00:00:00
abstract：PURPOSE:It has been suggested that routine division of short gastric vessels (SGVs) results in a more "floppy" Nissen fundoplication leading to improved outcomes, that is, less dysphagia and lower incidences of recurrent gastroesophageal reflux disease (GERD). The aim of this retrospective study was to assess whether l...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.10.016
更新日期：2006-01-01 00:00:00
abstract：BACKGROUND/PURPOSE:Vascular disruption is recognized as a cause of congenital malformations. The authors analyzed the significance of single umbilical artery (SUA) in the Adriamycin-animal model to find out if it was associated with organ malformations. METHODS:Pregnant SD rats were injected with Adriamycin intraperit...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2003.08.046
更新日期：2003-12-01 00:00:00
abstract：:This study reviews our experience from 1977 to 1991 with 32 children born with esophageal atresia and tracheoesophageal fistula (EA-TEF) who later underwent surgery for severe tracheomalacia. Indications for surgery included dying spells (21), inability to extubate the airway (nasotracheal tube 5, tracheotomy 3), and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90575-r
更新日期：1992-08-01 00:00:00
abstract：:In 31 cases of Hirschsprung's disease, the mean value of erythrocyte AChE activity was discovered to be 91.24 +/- 10.24 u/mL, being significantly higher than that from 127 normal children of 73.51 +/- 9.36 u/mL (P less than 0.001); whereas serum ChE mean value of 14.49 +/- 4.04 u/mL showed no difference from normal co...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80187-6
更新日期：1984-06-01 00:00:00
abstract：BACKGROUND/PURPOSE:Obstructive symptoms in a patient post-Ladd procedure raise the question of recurrent volvulus. Our objective is to determine the incidence and the radiographical evaluation of recurrent volvulus and abdominal complications after a Ladd procedure. METHODS:One hundred ninety-five patients who underwe...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.03.018
更新日期：2011-09-01 00:00:00
abstract：:Survival has improved dramatically for children with extrahepatic biliary atresia (EHBA), but optimal surgical management remains controversial. We have studied 28 infants born between June 1981, and April 1988, who underwent Kasai's portoenterostomy as primary surgical treatment. Those with evidence of subsequent hep...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(05)80182-4
更新日期：1990-01-01 00:00:00
abstract：PURPOSE:Under a Food and Drug Administration directive, we examined definite long-term safety and efficacy aspects of an engineered diaphragmatic tendon graft as a regulatory prerequisite for clinical trials. METHODS:Newborn lambs (N = 27) underwent partial diaphragmatic replacement with a Teflon patch, a composite ac...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.09.063
更新日期：2011-01-01 00:00:00
abstract：:The authors discuss a case of hereditary angioneurotic edema in a child presenting with recurrent episodes of colocolic intussusception, each successfully reduced by air enema. Although additional manifestations of vasogenic edema are potential risks of the procedure, these were not encountered. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.03.075
更新日期：2004-07-01 00:00:00
