title: [Laparoscopic vs opened appendicovesicostomy in pediatric patients].
abstract: BACKGROUND
  Appendicovesicostomy is commonly employed to facilitate drainage of urine through the catheter. Due to the tendency to less invasive procedures for the treatment of patients with neurogenic bladder, laparoscopy has been used as an alternative to open surgery, with the immediate advantages of postoperative recovery, shorter postoperative ileus, better cosmetic results, lower postoperative pain and early reintegration into everyday life.
  
  
  OBJECTIVE
  Compare the results of laparoscopic procedure with open appendicovesicostomy.
  
  
  METHODS
  We conducted an observational, analytical, longitudinal, ambispective cohort study, which included patients from 6-16 years of age diagnosed with neurogenic bladder, operated through laparoscopic and open appendicovesicostomy from January 2009 to June 2013. Information was obtained from clinical records. Six patients were operated laparoscopically and 14 by open approach.
  
  
  RESULTS
  Surgical time was longer and statistically significant in the laparoscopic group with a median of 330 min (300-360 min) compared to open procedure of 255 min (180-360 min). Seven patients had complications in the open group and only one in the laparoscopic group. The difference in the dose of analgesics and time of use was statistically significant in favor of the laparoscopic group. The degree of urinary continence through the stoma was higher for laparoscopic (100%) compared to the open procedure (64%).
  
  
  CONCLUSIONS
  In neurogenic bladder with urodynamic bladder capacity and leak point pressure bladder within acceptable values, laparoscopic appendicovesicostomy was a better alternative.
authors.affiliation: Servicio de Urología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, DF, Mexico. milanda@prodigy.net.mx;
authors.forename: Sergio
authors.initials: S
authors.lastname: Landa-Juárez
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital General de Zona 32, Instituto Mexicano del Seguro Social, México, DF, Mexico.
authors.forename: Lorena Elizabeth
authors.initials: LE
authors.lastname: Montes de Oca-Muñoz
authors.affiliation: Servicio de Urología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, DF, Mexico.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Castillo-Fernández
authors.affiliation: Servicio de Urología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. México, DF, Mexico.
authors.forename: Hermilo
authors.initials: H
authors.lastname: de la Cruz-Yañez
authors.affiliation: Servicio de Cirugía Pediátrica, Star Médica Infantil Privado, México, DF, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: García-Hernández
authors.affiliation: Servicio de Pediatría, Hospital Médica Sur, México, DF, Mexico.
authors.forename: Roxona
authors.initials: R
authors.lastname: Andraca-Dumit
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D000700:Analgesics / Q000627:therapeutic use; D001065:Appendix / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D057928:Intermittent Urethral Catheterization / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008591:Meningomyelocele; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D013724:Teratoma; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
chemical_list: D000700:Analgesics
keywords: Appendix; apéndice; bladder; cistostomía; cystostomy; derivación urinaria; laparoscopia; laparoscopy; urinary diversion; vejiga