Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 1034
Function: getPubMedXML
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3152
Function: GetPubMedArticleOutput_2016
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Purpose: Minimally invasive surgery has been gaining momentum in pediatric urology and it is essential to analyze the unique complications pertinent to this approach. We conducted a systematic review to evaluate pediatric minimally invasive surgery complications in the published urological literature.
Materials And Methods: We searched PubMed®/MEDLINE® using relevant pediatric minimally invasive surgery terminology and applied specified eligibility criteria. The Clavien-Dindo classification scheme was used to categorize postoperative complications. For studies not using Clavien-Dindo, complications were recategorized into Clavien-Dindo grades. Primary outcome was frequency of grade III complications and conversions to open surgery. Covariates were surgery type (pyeloplasty, nephrectomy, partial nephrectomy, ureteral reimplantation and complex reconstruction) and surgical approach (laparoscopic, robotic assisted and/or laparoendoscopic single site). Proportions were compared using the chi-square test (α=0.05).
Results: Overall 123 studies met the inclusion criteria, reporting outcomes of 5,864 patients. About a third (35.8%) of studies used the Clavien-Dindo classification. Nephrectomy had a significantly lower frequency of grade III complications (1.18%) compared to pyeloplasty (3.64%), ureteral reimplantation (6.65%) and complex reconstruction (11.76%) (p <0.05). Complex reconstruction had a significantly higher frequency of grade III complications (11.39%) compared to all other analyzed surgeries (p <0.05).
Conclusions: The rate of complications and open conversions varies by surgical procedure in pediatric urological minimally invasive surgery. Despite the existence of a standardized complication classification system, the majority of reviewed publications did not report complications in a standardized fashion. Our findings call for more robust studies in pediatric minimally invasive surgery and universal implementation of standardized complication reporting.
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Source |
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http://dx.doi.org/10.1097/JU.0000000000000707 | DOI Listing |
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