Outcomes of laparoscopic continent catheterizable conduit procedures in children with neurogenic bladder: An 8-year experience in a single center.

BACKGROUND

The continent catheterizeable conduit (CCC) procedure plays an important role in the treatment of children with neurogenic bladder. Laparoscopic procedures offer significant benefits; however, the potential complications should not be ignored.

OBJECTIVE

By comparing the complications of CCC in laparoscopic and open neurogenic bladder operations in our center, we aimed to explore the advantages of laparoscopic CCC construction in children.

STUDY

DESIGN

All the cases of neurogenic bladder who had undergone laparoscopic or open lower urinary tract reconstruction at our hospital from June 2009 to December 2016 were retrospectively reviewed. We compared the rates of various complications in the laparoscopic and open groups as well as the appendix and Yang-Monti groups.

RESULTS

61 patients were included in this study. Laparoscopic CCC procedure was performed in 45 cases, 9 were converted to open owing to other combined procedures. Open CCC construction was performed in 16 cases. The mean follow-up time was 4.5 years. Catheterization was safe and uneventful in 72.1% of patients. Complications occurred in 17 cases, including stoma stenosis (n = 5), leakage (n = 5), mucosal prolapse (n = 3), conduit atresia (n = 3), and angulation of the conduit (n = 1). Eleven cases received surgical revision. There were no statistically significant differences in complication type or rate in the laparoscopic and open group, or in the appendix and Yang-Monti group.

DISCUSSION: Although our study showed a notable complication rate associated with CCC, this did not differ for open and laparoscopic procedures, and laparoscopic procedures can achieve satisfactory results comparable to open procedures.

CONCLUSION

From our single center's experience of lower urinary tract reconstruction, laparoscopic CCC surgery has a shorter hospital stay and no more complications than the open procedure. It is a safe and feasible procedure in children.