Comparison between internal double J and external pyeloureteral stents in open pediatric pyeloplasty: A multicenter study

Sarhan, Osama; Awwad, Ahmed; Otay, Abdulhakim Al; Faddagh, Abdulmohsin Al; Helaly, Ahmed El; Ghanbar, Mustafa Al; Kawai, Fouad Al; Nakshabandi, Ziad

doi:10.1016/j.jpurol.2021.03.027

Cited by 6 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Combined with the above discussions, we find that stent-less pyeloplasty is the most minimally invasive, but it has a high incidence of urinary leakage. Combined with the results of the other studies ( 5 , 6 , 10 , 15 – 17 ), we found that the advantages of the DJ stent are that it is safe, reliable, effective, and more minimally invasive, while the removal time of the PU stent is shorter, which can reduce the occurrence of catheter-related complications. And the disadvantages are obvious too, such as issues with anesthesia during DJ stent removal and the high risk of urine leakage associated with the PU stent.…”

Section: Discussionsupporting

confidence: 68%

“…Compared with other reported literature (5,8,(13)(14)(15)(16), the advantages of our study lie in the long follow-up time and importantly in the number of patients. To our knowledge, this is the first long-term follow-up of TEUS and study of the results.…”

Section: Discussionmentioning

confidence: 81%

“…At present, there are two kinds of stent tubes widely used: the DJ stent and PU stent. Recently, Sarhan et al ( 5 ) reported a multicenter study of the efficacy of drainage methods in 175 children between the two groups, which showed no significant difference in the incidence of postoperative complications or long-term outcomes. DJ stent insertion provides a shorter hospital stay, but a second operating room visit and anesthesia for removal are unavoidable.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first descriptions of laparoscopic pyeloplasty (LP) in 1993 by Schlussel ( 2 ) and in 1995 by Peters ( 3 ), LP has become the gold standard in the treatment of UPJO, with its safety and minimal invasiveness. Usually, surgeons will choose to use a drainage stent after pyeloplasty; however, which drainage method is the best choice is still quite controversial ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…After LP, the choice of stent type has always been the focus of debate. For now, double-J (DJ) stent and percutaneous transanastomotic (PU) are widely used due to their reliable efficacy, but their disadvantages are also obvious, such as displacement and secondary anesthesia in the DJ stent (5)(6)(7)(8) and urine leakage, kinks, and obstruction in the PU stent (5,9,10). Therefore, the ideal drainage method should be effective while being minimally invasive and safe.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparison of Drainage Methods After Pyeloplasty in Children: A 14-Year Study

Kong

et al. 2021

Front. Pediatr.

View full text Add to dashboard Cite

Objective: To summarize our experiences with drainage methods after laparoscopic pyeloplasty with a 14-year study.Methods: We reviewed the data of the 838 children operated on for hydronephrosis due to congenital ureteropelvic junction obstruction (UPJO) between July 2007 and July 2020. Patients' demographics, perioperative details, postoperative drainage stents [including double-J stent, percutaneous trans-anastomotic (PU) stent, and trans-uretero-cystic external urethral stent (TEUS)], complications, hospital stay, and long-term follow-up outcomes were analyzed. Long-term follow-up was performed by outpatient visits and telephone follow-up. Moreover, we reviewed the details of nine cases of recurrence after laparoscopic pyeloplasty.Results: Comparison of preoperative general data among the three groups indicated that there was no statistical difference in age, gender, and surgical side of the three groups. Statistical differences were found in the incidence of postoperative complications from the three postoperative drainage method groups, especially the incidence of reoperations (p < 0.01): there were six cases (3.19%) of recurrences in the TEUS group, two cases (0.36%) in the DJ group, and one case (0.93%) in the PU group. In the six recurrent cases from the TEUS group, four cases (44.4%) were found to have stenosis, and two cases (22.2%) have iatrogenic valvular formation.Conclusion: Not all three types of drainage methods are suitable for drainage after pyeloplasty. Based on our findings, TEUS is not recommended.

show abstract

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of Drainage Methods After Pyeloplasty in Children: A 14-Year Study

Kong

et al. 2021

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

Risk factors for adverse outcomes after pediatric pyeloplasty: A retrospective cohort study

Zouari,

Dghaies,

Rhaiem

et al. 2023

Int J of Urology

View full text Add to dashboard Cite

PurposeTo identify the risk factors for adverse outcomes after pediatric pyeloplasty.MethodsWe conducted a retrospective review of all children under the age of 14 years who underwent primary pyeloplasty for unilateral ureteropelvic junction (UPJ) obstruction at a single teaching hospital in Tunisia between January 1, 2013, and December 31, 2022.ResultsA total of 103 patients were included. Median age of patients at surgery was 27 months (interquartile range [IQR], 13–44). On ultrasound, median renal pelvic anteroposterior diameter was 3.2 cm (IQR, 2.3–4), and the median renal cortex thickness (RCT) was 2.5 mm (IQR, 2–3.5). Median differential renal function (DRF) on preoperative radionuclide renal scan was 40% (IQR, 30–46). Postoperative adverse outcomes occurred in 28 patients (27.2%). These included 19 cases of urinary tract infections (UTIs), 11 cases of UPJ restenosis, four cases of UPJ leakage, two cases of urinoma, and two cases of diversion‐related complications. Multivariate logistic regression analysis revealed two factors significantly and independently related to postoperative negative outcomes: RCT <3 mm and DRF > 50%.ConclusionOur study demonstrated that preoperative RCT on ultrasound of less than 3 mm and preoperative DRF on radionuclide renal scan of more than 50% were independent risk factors for adverse outcomes following pediatric pyeloplasty. These factors could be of interest in identifying, early on, patients who will develop postoperative negative outcomes, giving them more attention and support, and explaining the prognosis to the patient and family.

show abstract

Double J stent combined with pyelostomy tube in pediatric laparoscopic pyeloplasty: a 5-year clinical experience in a single center

Chen,

Wang,

et al. 2023

BMC Urol

View full text Add to dashboard Cite

Objective To compare the outcome of using a double J (DJ) stent combined with pyelostomy tube with a DJ stent alone in laparoscopic pyeloplasty (LP) for pediatric ureteropelvic junction obstruction (UPJO). Methods A retrospective review of all patients with UPJO treated with LP between January 2017 and November 2021 was conducted in our center. According to different postoperative drainage methods patients were divided into a DJ stent group (52 cases) and a DJ stent combined with pyelostomy tube group (combination group, 41 cases). Operative time, bleeding volume, perirenal drainage stent removal time, postoperative hospital stay, postoperative complications, and renal function recovery were compared between the two groups. Renal ultrasound and diuretic renogram (DR) were used for preoperative and postoperative follow-up. Results A total of 52 patients were in the DJ stent group and 41 patients in the combination group. The mean hospital stay was 6.46 ± 2.66 days in the DJ stent group and 5.22 ± 1.63 days in the combination group (p < 0.05). Postoperative complications developed in 14 out of 52 patients in the DJ stent group (26.9%), while complications developed in 8 out of 41 patients in the combination group (19.5%) (p > 0.05). Non-catheter-related complications developed in 10/52 patients in the DJ stent group (19.2%) and only 1/41 patients in the combination group (2.4%) (p < 0.05). The renal function and renal cortex thickness in both groups were improved. Conclusion Both the DJ stent drainage and the DJ stent combined with pyelostomy drainage are safe and effective. We should fully consider the patient’s preoperative and intraoperative conditions and choose appropriate drainage methods. A DJ stent combined with pyelostomy tube can reduce non-catheter related complications, facilitate postoperative recovery, and the hospital stay was significantly shorter than the DJ stent group. However, it is necessary to pay attention to the nursing treatment of the pyelostomy tube and guard against the occurrence of pyelostomy tube shedding.

show abstract

Comparison between internal double J and external pyeloureteral stents in open pediatric pyeloplasty: A multicenter study

Cited by 6 publications

References 18 publications

Comparison of Drainage Methods After Pyeloplasty in Children: A 14-Year Study

Comparison of Drainage Methods After Pyeloplasty in Children: A 14-Year Study

Risk factors for adverse outcomes after pediatric pyeloplasty: A retrospective cohort study

Double J stent combined with pyelostomy tube in pediatric laparoscopic pyeloplasty: a 5-year clinical experience in a single center

Contact Info

Product

Resources

About