A novel technique of stenting for laparoscopic pyeloplasty in children

Eassa, Waleed; Zahrani, Ahmed Al; Jednak, Roman; El‐Sherbiny, Mohamed; Capolicchio, John-Paul

doi:10.1016/j.jpurol.2010.10.010

Cited by 16 publications

(17 citation statements)

References 21 publications

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“…Antegrade stenting can also be performed in 2 different ways such as; internal DJ stent and external pyelo-nephroureterostomy tube placement. There are numerous publications assessing the effectivity of those 3 main approaches [11,12,13,14,15,16]. It has been shown that despite their own advantages, many of those techniques have some drawbacks.…”

Section: Discussionmentioning

confidence: 99%

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

Kalkan

Ersöz²,

Armağan³

et al. 2016

Urol Int

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Objective: There are 2 critical steps of stent placement during laparoscopic pyeloplasty (LP) in children. Introduction to the ureteropelvic junction and passing through the ureterovesical junction. We aimed at overcoming those 2 steps by creating a modified technique. Methods: Consecutive 27 children undergoing transperitoneal laparoscopic dismembered pyeloplasty by a single surgeon were prospectively enrolled into this study. The modifications of our technique are using an Amplatz dilator and a closed tip stent. Results: The mean age of the children was 6.7 (range 4 months-17 years). The mean time of stent insertion was 2.7 ± 2.0 (2-6) min and the operative time was 128.3 ± 17.6 (90-180) min. The mean number of days of hospital stay was 2.0 ± 0.4 (1-3). After a mean follow-up period of 20.3 ± 4.2 (14-30) months, no operative failure was detected. Conclusion: Our modified technique is a completion of the current armamentarium for stent placement during LP in infants and children.

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Section: Discussionmentioning

confidence: 99%

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

Kalkan

Ersöz²,

Armağan³

et al. 2016

Urol Int

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“…No urine leaks were seen in their patients after removal. 12 Recently, a series of young children (ages 1-5 years) undergoing laparoscopic pyeloplasty compared outcomes of patients undergoing "stentless" pyeloplasty, pyeloplasty with DJ stent and EUP. The authors' interpretation of their data led them to conclude value in limiting use of a stent for children with unfavourable intra-operative findings (such as subjective appearance of the pelvis or ureter, malrotation, solitary kidney, presence of fibrosis).…”

Section: Discussionmentioning

confidence: 99%

“…Employed surgical techniques have been previously reported, 12 with minor modifications. An abdominal radiograph depicting bilateral EUP stents in situ is shown is Figure 1.…”

Section: Methodsmentioning

confidence: 99%

“…The laparoscopic approach has been previously described. 12 EUP stents were clamped at the end of the surgery (Fig. 2c), and indwelling Foley catheters were removed right after surgery or during the first 12 hours (according to surgeon preference).…”

Section: Methodsmentioning

confidence: 99%

“…The kidney internal splint/ stent (KISS) stent (Cook Urological, Spencer, IN), 8 Original research retroperitoneal, and laparoscopic trans-peritoneal pyeloplasties, and appears safe and feasible. [10][11][12] Literature directly comparing drainage with trans-anastomotic stents externalized through the renal pelvis versus DJ stents in children undergoing both laparoscopic and open pyeloplasties is limited. We sought to compare outcomes of both open and laparoscopic pyeloplasty using EUP and DJ stents.…”

Section: Introductionmentioning

confidence: 99%

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Impact of drainage technique on pediatric pyeloplasty: Comparative analysis of externalized uretero-pyelostomy versus double-J internal stents

Lee

Kanaroglou

Gleason

et al. 2015

CUAJ

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Introduction: Pediatric pyeloplasty with double J (DJ) stent drainage requires manipulation of the uretero-vesical junction (UVJ) and a second anesthetic for removal. Externalized uretero-pyelostomy (EUP) stents avoid these issues. We report outcomes of laparoscopic and open pyeloplasty with EUP compared to DJ stents in children. Methods: We retrospectively reviewed 76 consecutive children who underwent pyeloplasty for ureteropelvic junction (UPJ) obstruction over a 1-year period by 5 pediatric urologists at a single institution. The exclusion criteria included patients with concomitant urological procedures, other urinary drainage strategies, "stentless" pyeloplasty or patients without follow-up data. Based on surgeon preference, 24 patients had a EUP stent and 38 had a DJ stent placed. Results: The mean follow-up was 23.8 ± 10.9 months and 21.1 ± 11.1 months for the EUP and DJ stent groups, respectively (p = 0.32). The mean age was 40 ± 54 months and 80 ± 78 months for the EUP and DJ groups, respectively (p = 0.04). The EUP group had a greater proportion of open pyeloplasties (n = 17, 71%) versus the DJ group (n = 16, 42%; p = 0.04). There were no statistically significant differences in operative time, length of stay, and overall complication rate between groups. Complications were divided by timing of complication (intraoperative, before and after 3 months) and according to the Clavien Classification system. There were no statistically significant differences between these subgroups. The limitations of this study include small sample size, potential selection bias, and heterogeneity between both study groups. Conclusions: Pyeloplasty using EUP stents does not incur prolonged operative time, longer length of stay or higher complication rate when compared to DJ stents. Within the limitations of this study, EUP stents may be a safe alternative to DJ stents.

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

et al. 2013

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A novel technique of stenting for laparoscopic pyeloplasty in children

Cited by 16 publications

References 21 publications

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

Impact of drainage technique on pediatric pyeloplasty: Comparative analysis of externalized uretero-pyelostomy versus double-J internal stents

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

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