Work

Stented Versus Nonstented Pediatric Pyeloplasty: A Modern Series and Review of the Literature

Year: 2002

Type: article

Abstract: PURPOSE: Dismembered pyeloplasty remains the principal surgical therapy for pediatric ureteropelvic junction obstruction, although the method of postoperative drainage continues to be debated. We compared stented versus nonstented repairs in a modern series. MATERIALS AND METHODS: We evaluated 117 pediatric dismembered pyeloplasties performed by 3 pediatric urologists at 2 institutions from 1991 to 2000. Hospital stay, success rate and complication rate were reviewed. Results were compared with 833 evaluable cases in the literature. RESULTS: Of the 52 stented repairs urological complications developed in 6 (12%), including symptomatic urinary tract infection in 3 and temporary obstruction in 3. Of the 65 nonstented repairs urological complications developed in 10 (15%), including prolonged leakage in 3, urinoma in 3, obstruction in 3 and urinary tract infection in 1. Mean hospitalization plus or minus standard error was shorter in the stented group (2.1 +/- 0.89 versus 2.6 +/- 1.1 days, p <0.02). We identified 9 previous studies comparing a total of 339 stented with 494 nonstented repairs. Overall the number of complications was almost equal (12% versus 14%) but the stented group had more infections, whereas more leaks occurred in the nonstented group. The nonstented group required more secondary procedures (12 of 339 versus 45 of 494, p = 0.003). Hospital stay was 12 days for stented and 5 days for nonstented repair in these earlier series. CONCLUSIONS: In children the outcome of stented pyeloplasty is similar to that of nonstented repair. In contrast to previous reports, using a stent for drainage should not necessitate a longer hospital stay.

Source: The Journal of Urology

DOI: 10.1016/s0022-5347(05)64607-1

Authors: Karen E. Smith, Nicholas Holmes, Jeremy I. Lieb, James Mandell, Laurence S. Baskin, Barry A. Kogan

Institutions: University of California, San Francisco, University of California San Francisco Medical Center, Albany Medical College

Language: English

Topic: Pediatric Urology and Nephrology Studies

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,000