Comparison of external stents and DJ stents techniques for pediatric pyeloplasty: A systematic review and meta-analysis

Abstract

ObjectiveTo evaluate and compare the efficacy and safety between an external stent and a Double J stent for pediatric Pyeloplasty.MethodsThrough a systematical search of multiple scientific databases in July 2022, we performed a systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), whose protocol was registered with PROSPERO(CRD42021274087).ResultsEleven studies involving 1,758 patients were included. No significant differences were observed in operative time (MD: 2.26; 95% CI −9.62 to 14.14; P = 0.79), operative success rate (OR: 1.10; 95% CI 0.57 to 2.10; P = 0.780), length of hospital stay (MD: 0.65; 95% CI −0.04 to 1.34; P = 0.063), or complications (OR: 0.87; 95%CI 0.48 to 1.56; P = 0.630) between external stents and DJ stents in pediatric pyeloplasty. According to the subgroup analysis, we found the external stent group had a shorter operative time than the DJ stent group in terms of robot-assisted laparoscopic pyeloplasty (MD: −17.13; 95% CI −32.8 to −1.45; P = 0.032).ConclusionsThere were no significant differences in operative time, operative success rate, length of hospital stay, or complications between external stents and DJ stents in pediatric pyeloplasty. The external stented procedure seemed to have less operative time when using robot-assisted laparoscopic pyeloplasty. However, due to the limitations of our analysis, more studies are still required to support our conclusion.Systematic review registrationThis systematic review has been registered on PROSPERO, the registration ID is CRD42021274087.

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

“…Although double J stented technique seemed to be more beneficial for pediatric pyeloplasty than other methods, the authors found no obvious differences between the three diversion techniques with respect to overall complications, operative time, hospital stay, success rate, and improvement of renal functions. 26 Despite the apparent divergence between the two risk factors for adverse outcomes identified by our study, we suggest that these factors are in perfect harmony. A low DRF (i.e., <35%-40%) or a decrease in DRF on repeated renal scans are usually accepted as the main indications for surgery.…”

“…However, there was no relationship between diversion type (double J stent or ureteral catheter) and outcomes. 7 In a recent meta-analysis, Meng et al 26 investigated the safety and effectiveness of external stenting, double J stenting, and unstented diversion techniques in pediatric pyeloplasty. Although double J stented technique seemed to be more beneficial for pediatric pyeloplasty than other methods, the authors found no obvious differences between the three diversion techniques with respect to overall complications, operative time, hospital stay, success rate, and improvement of renal functions.…”

“…However, there was no relationship between diversion type (double J stent or ureteral catheter) and outcomes 7 . In a recent meta‐analysis, Meng et al 26 . investigated the safety and effectiveness of external stenting, double J stenting, and unstented diversion techniques in pediatric pyeloplasty.…”