Objective pain assessment after ureteral reimplantation: Comparison of open versus robotic approach

Summary Introduction While open ureteral reimplantation is the gold standard of surgical intervention for vesicoureteral reflux (VUR), minimally invasive approaches offer the potential benefits of decreased postoperative pain, improved cosmesis, and shorter hospital stay and convalescence. Studies c...

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Bibliographic Details
Published in:Journal of pediatric urology 2015-04, Vol.11 (2), p.82.e1-82.e8
Main Authors: Harel, M, Herbst, K.W, Silvis, R, Makari, J.H, Ferrer, F.A, Kim, C
Format: Article
Language:English
Subjects:
Adolescent
Analgesics, Opioid - administration & dosage
Child
Child, Preschool
Cohort Studies
Follow-Up Studies
Humans
Infant
Pain
Pain Measurement
Pain, Postoperative - diagnosis
Pain, Postoperative - drug therapy
Pediatrics
Prospective Studies
Reimplantation
Replantation - adverse effects
Replantation - methods
Robotic Surgical Procedures - adverse effects
Robotic Surgical Procedures - methods
Robotics
Treatment Outcome
Ureter - surgery
Urologic Surgical Procedures - adverse effects
Urologic Surgical Procedures - methods
Urology
Vesico-Ureteral Reflux - diagnosis
Vesico-Ureteral Reflux - surgery
Vesicoureteral reflux
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Summary:Summary Introduction While open ureteral reimplantation is the gold standard of surgical intervention for vesicoureteral reflux (VUR), minimally invasive approaches offer the potential benefits of decreased postoperative pain, improved cosmesis, and shorter hospital stay and convalescence. Studies comparing open and minimally invasive surgery with respect to postoperative pain in children have been inconclusive. Objective We sought to compare postoperative pain in children undergoing open versus robotic ureteral reimplantation by using age-appropriate, validated pain assessment scales. Methods A prospective cohort of all patients enrolled in an Institutional Review Board-approved VUR surgery registry between July 2010 and February 2013 was analyzed. Patients who underwent endoscopic treatment or who received caudal or epidural anesthesia were excluded. Age-appropriate, validated pain scales ranging from 0 to 10 were utilized for pain assessment. Pain scores and narcotic doses administered on the first postoperative day were analyzed. Results Of the 34 subjects included, 11 underwent open intravesical reimplantation, while 23 patients underwent robotic extravesical reimplantation. Table 1 displays patient characteristics and results of pain assessment. Robotic surgery was associated with lower narcotic requirement compared to open surgery ( P  
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2014.12.007