ESPU Congress 2018 - Abstract Book

119 11–14 APRIL, 2018, HELSINKI, FINLAND 09:22–09:25 S14-6 (PP) RETROPERITONEOSCOPIC PYELOPLASTY DRAINAGE, TRANSPELVIC IS THE WAY! Joana LOPES  1 , Oliver SANCHEZ  2 , Andrew ROBB  1 , Liam MCCARTHY  1 , Karan PARASHAR  1 and Harish CHANDRAN  1 1) Birmingham Children's Hospital, Paediatric Surgery and Urology, Birmingham, UNITED KINGDOM - 2) Centre Hospitalier Universitaire Vaudois, Department of Pediatric Surgery, Lausanne, SWITZERLAND PURPOSE There is a wide variety in post-operative pyeloplasty drainage practices. Our previous practice con- sisted of cystoscopy for JJ stent insertion, followed by patient repositioning for retroperitoneoscopic pyeloplasty (RPP), and stent removal at 6 weeks under general anaesthetic. We have recently changed to a simplified percutaneous drainage (PD), by transanastomotic stenting with a shortened Salle intraoperative pyeloplasty stent (Cook® Medical) introduced through the pelvis. MATERIAL AND METHODS We analysed the short-term results of our first 32 PD cases (Group 2) versus the previous 32 in- ternally drained (ID) patients (Group 1) with a retrospective review of case notes collecting demo- graphic data, operative details, post-operative course including re-admissions, symptomatic leak and urinoma, early recurrence, reoperation, drainage malfunction or problem during stent retrieval. Comparisons were made by Mann-Whitney test, p<0.05 taken as significant. RESULTS 64 consecutive retroperitoneoscopic pyeloplasties were analysed, performed between August 2014 and October 2017. Mean age in our cohort was 8,1 +/- 5,5 years, 1F : 1.6M. Mean operative time in Group 2 was 144 +/- 6,5 min while it was 181 +/- 8,2 min in Group 1 (p = 0.001). The post-operative median length of stay was 2 days in both groups. 2 patients needed reoperations in PD Group - one stent retrieval failure, and one for JJ stent insertion. In the ID Group - 2 patients needed reoperations for drainage of urinoma; one patient needed a cystotomy at time of JJ removal due to failure to retrieve stent. In each group there was one readmission due to pain, without further interventions. CONCLUSIONS The percutaneous drainage has significantly shortened the overall procedure time, avoided lower urinary tract instrumentation in 97 % of patients and avoided an additional general anaesthetic in 94 %. There was no increase in early complications or readmissions and no symptomatic urine leaks. We will further analyse the mid and long term results.