Treatment outcomes and complications of gastrocystoplasty: a comparison between pediatric and adult patients
Associate Professor Phitsanu Mahawong (1), Doctor Jaraspong Vuthiwong (1), Professor Bannakij Lojanapiwat (1), Doctor Wilaiwan Chongruksut (2)
(1) Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Thailand, (2) Research Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Thailand
Gastrocystoplasty has been used for treating refractory bladder dysfunction for decades. The treatment outcomes and complications may be related to the age of the patients. The objective of this study is to compare pediatric and adult gastrocystoplasty in terms of early and late outcomes and complications plus pre and postoperative urodynamic parameters.
The clinical data of the 50 patients who underwent gastrocystoplasty between 2006-2016 were retrospectively reviewed and 41 patients who had eligible data were included. There were 14 (5 boys, 9 girls) pediatric patients (group I) with a mean age of 10.92.6 years old and there were 27 (11 men, 16 women) adult patients (group II) with a mean age of 40.612.8 years old. The data were compared and analyzed between the two groups.
The mean operative times were 401.4390.8 minutes in group I and 401.1195.9 minutes in group II (p=0.992). The mean estimated blood losses were 292.86155.49 ml in group I and 448.15483.67 ml in group II (p=0.137). The mean postoperative hospital stays were 18.66.7 days in group I and 20.011.4 days in group II (p=0.634). There were no major early complications in both groups. The mean postoperative follow up times were 4.943.1 years in group I and 5.043.3 years in group II (p=0.922). There were major late complications in 3/14 (21.43%) cases in group I, while 11/27 (40.74%) cases in group II (p=0.305). The mean increased bladder capacity at 30 cmH2O were 227.33147.80 ml in group I and 346.00203.87 ml in group II (p=0.147). The mean percentages of increased bladder capacity at 30 cmH2O were 231.68254.34 percent in group I and 354.65260.45 percent in group II (p=0.278).
Gastrocystoplasty in children had same treatment outcomes and complications as in adults. However, a prospective study with a greater number of patients is required.