Enterocystoplasty and appendicovesicostomy in adults: a description of demographics and 30-day outcomes of bladder augmentation.

ABSTRACT

Within the adult population, studies of the granular clinical outcomes of appendicovesicostomy (AV) and augmentation enterocystoplasty (AE) have been limited to case series. Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data, this study sought to describe the population undergoing these procedures. An analysis of the ACS NSQIP database (2015 to 2018) was performed, capturing patients with procedure codes of enterocystoplasty with intestinal anastomosis or cutaneous appendicovesicostomy. Patients were stratified into three groups, if they underwent either procedure, or both procedures. Demographics, comorbidities, perioperative variables, surgeon specialty, and outcomes were described. 130 patients undergoing AV or AE were captured. Most of these patients were white (70.77%) and middle aged (46.78±17.33 years). Most patients were an American Society of Anesthesiologists class 3 or greater risk (71.54%). A higher percentage of AE patients were readmitted, returned to the operating room, and had postoperative UTI or sepsis compared to those undergoing AV or AV+AE. The most common complication overall was readmission related to the operation (14.62%). The most common postoperative diagnosis was neurogenic related in over half of cases. The study shows patients undergoing bladder augmentation and appendicovesicostomy are readmitted not infrequently. Risk of infection, sepsis, bleeding, and reoperation are also not insignificant. Further studies should be carried out to aid in decreasing complication rate and readmissions after these procedures.