External extension of double-J ureteral stent during pyeloplasty: inexpensive stent and non-cystoscopic removal

Kajbafzadeh, Abdol‐Mohammad; Zeinoddini, Atefeh; Ebadi, Maryam; Heidari, Reza; Tajalli, Afshin

doi:10.1007/s11255-013-0594-9

Cited by 11 publications

(3 citation statements)

References 19 publications

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“…Importantly, application of externalized double-J stents in infants with UPJO was studied and no severe complications were observed, along with a relatively shortened operative time. 11 Because placement of double-J stents is still controversial in UPJO treatment, one clinical study focused on adult patients and compared stented and stentless techniques after LP surgery. 12 Stentless LP is more feasible than LP with stents, but it requires more experienced surgeons and it has more complications.…”

Section: Discussionmentioning

confidence: 99%

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

et al. 2020

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Objectives We aimed to investigate the safety concerns associated with placing double-J ureteric stents post-laparoscopic pyeloplasty surgery for congenital ureteropelvic junction obstruction (UPJO) and hydronephrosis. Methods A total of 1349 patients with postoperative double-J stent placement at our center were included. Clinical variables for enrolled patients were collected by two independent authors. We compared clinical variables and the efficacy of stenting post-laparoscopic pyeloplasty. Results The mean age of the patients was 4.23 ± 2.39 years. A total of 58.49% of patients were diagnosed with left UPJO with hydronephrosis and 33.95% were diagnosed with right UPJO. Furthermore, 7.56% of patients had bilateral UPJO. In all cases, 96.96% of indwelling double-J stents were successfully removed 4 weeks post-surgery. A total of 3.04% of the patients still required further management, including stent migration to the renal pelvis (0.37%), stent migration to the bladder (0.30%), prolapse of the stent through the ureter (0.15%), blockage of stents (1.85%), and fouling of stents (0.37%). Conclusions Double-J ureteric stents used after laparoscopic pyeloplasty for treating UPJO in hydronephrosis for pediatric patients is a safe, feasible, and beneficial method, which can be recommended for routine procedures. However, caution should be practiced for follow-up and removal using this method.

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Section: Discussionmentioning

confidence: 99%

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

et al. 2020

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“…Ureteral mobilization is discussed for reducing the ureteral blood supply in many studies. [ 9 , 11 ] While performing the ureteral mobilization, we considered the possibility of decreased blood flow to ureter but we did not detect any problem and used this technique safely.…”

Section: Discussionmentioning

confidence: 99%

Impact of Extracorporeal Stent Placement During Laparoscopic Pyeloplasty on Operative Duration

Demirkan

Horasanlı

2020

Sisli Etfal

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Objectives: Ureteric stent insertion during laparoscopic pyeloplasty is the common practice for the reconstruction of ureteropelvic junction obstruction (UPJO). The long and hard learning curve of the method leads still controversy among surgeons. The utility of extracorporeal stent insertion in terms of shortening the length of operation time will be discussed in this study. Methods: A total of 36 children who underwent pyeloplasty for UPJO were evaluated retrospectively. Indications for pyeloplasty were: Obstruction findings in renal scintigraphy, progressive kidney function loss, increasing in anteroposterior pelvis diameter in renal ultrasonography, and current clinical symptoms (febrile urinary tract infection and flank pain). Extracorporeal stent insertion procedure was performed as the following order: Ureteropelvic area and ureter were visualized transperitoneal by three trochars, and UPJO was excised. Thereafter, the ureter is taken out of the skin from pelvic trochar entrance and is spatulated. JJ stent is placed into the ureter. Following this move, the ureter is taken into the intra-abdominal area and first ureteropelvic suture is performed intra-abdominally. Results: Thirteen of patients were girls and 23 were boys. Open surgery was applied for 15 patients (Group 1) and laparoscopic pyeloplasty (Group 2) to 21 patients. In Group 2, JJ stent was placed intracorporeally for six patients (Group 2a) and extracorporeally for the other 15 patients (Group 2b). The average age in Group 1 was 49.2±52 months; it was 86±29 months in Group 2a and 144±52 months in Group 2b, and the significant difference was present (p<0.001). There was statistically significant difference between Group 1 and Group 2 regarding with mean hospital stay (40 h in Group 1 and 42 h in Group 2; p=0.001). Post-operative JJ stent removal time was 58.8 days in Group 1 and 52.89 days in Group 2. In Group 2b patients, placing the stent extracorporeally took a significantly shorter operation time and the difference between the operation times of the groups (2a [192 min±3.76] and 2b [135 min±2.6] [p<0.001]) was statistically significant. No statistical difference was found between Group 1 (9.87±5.5 mm) and Group 2 (12.91±5.3 mm) in terms of renal anteroposterior diameters in the control ultrasonographic evaluation at the post-operative 2 nd year (p=0.23). There was no difference between the two groups as a result of the evaluation of renal functions by scintigraphy at the post-operative 1 st year (Group 1: 3.95±2%; and Group 2: 0.78±5.3%). Conclusion: According to the consequences in this study, extracorporeally ureteric stent insertion during laparoscopic pyeloplasty shortens the length of operation duration so that extracorporeal insertion might be preferred in cases where it is difficult to place the stent during laparoscopic pyeloplasty.

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“…Several new technologies and materials have been reported to facilitate the removal of the double-J tube through a non-cystoscopic approach. Some examples are as follows: the application of double-J tube with magnetic ends (1)(2)(3)(4), surgical techniques for external placement of the double-J tube (5), and the percutaneous antegrade removal technique (6). However, these methods have certain limitations, such as the high cost of materials, requirement of technical expertise and additional surgical interventions, which increase the risk of complications.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Safety of a Simple Non-cystoscopic Double-J Tube Removal Technique in Children

et al. 2021

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Objective: Double-J tube placement is an important procedure during upper urinary tract surgery. A primary drawback is the requirement of a second double-J tube removal under a cystoscope. Therefore, a simple and feasible alternative is required to remove the double-J tube without cystoscopy. The present study reported the feasibility and safety of a simple non-cystoscopic double-J tube removal technique.Method: We retrospectively analysed children who underwent pyeloplasty and ureterovesical reimplantation between June 2015 and August 2021. A simple device (a catheter with a suture) was used to pull out the double-J tube. Patient characteristics, detailed surgical procedures, success and complication rates and reasons for failure were evaluated.Result: A total of 613 children were included. The mean age of patients was 6.2 months (3 months−14 years). Non-endoscopic methods were used to remove the double-J tube in all except 6 patients (0.9%). Of the 6 patients who required ureteroscopy or cystoscopy, 4 had retraction of the double-J tube into the ureter, and 2 (0.6%) had bladder stones. Of the 613 patients, 479 (76.0%) required one attempt, 127 (20.1%) required two attempts and 19 (3.0%) required several attempts. No serious postoperative complications occurred in all patients. The most common complications were gross haematuria (22.5%), pain urinating (17.9%), difficulty in urinating (3.6%), foreskin injury (1.7%), and penile oedema (1.3%). No urethral strictures developed during the follow-up period.Conclusion: The study results demonstrated that the modified and simple non-cystoscopic double-J tube removal technique is a safe and an effective alternative to cystoscopy in clinical practise.

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External extension of double-J ureteral stent during pyeloplasty: inexpensive stent and non-cystoscopic removal

Cited by 11 publications

References 19 publications

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

Impact of Extracorporeal Stent Placement During Laparoscopic Pyeloplasty on Operative Duration

Feasibility and Safety of a Simple Non-cystoscopic Double-J Tube Removal Technique in Children

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