Is Antegrade Stenting Superior to Retrograde Stenting in Laparoscopic Pyeloplasty?

Mandhani, Anil; Goel, Shailendra; Bhandari, Mahendra

doi:10.1097/01.ju.0000116546.06765.d1

Cited by 70 publications

(56 citation statements)

References 11 publications

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“…Mandhani and colleagues reported laparoscopic pyeloplasty with antegrade stent insertion in 24 patients [Mandhani et al 2004]. This approach avoids the need to reposition the patient and, once mastered, can be performed in less than 10 minutes.…”

Section: Discussionmentioning

confidence: 99%

Stentless pediatric robotic pyeloplasty

Rodríguez¹,

Rich²,

Swana³

2012

Therapeutic Advances in Urology

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Abstract:Objectives: Open dismembered pyeloplasty remains the standard of care for the correction of ureteropelvic junction obstruction in children. We describe our experience with a tubeless, stentless pediatric robotic pyeloplasty technique. Methods: Between October 2008 and September 2009, 12 consecutive children underwent robotic dismembered pyeloplasty. Ureteral stents or nephrostomy tubes were not used. Operative time, hospital stay, days of Jackson-Pratt drainage, and complications were analyzed. Postoperative renal ultrasonography was obtained at 4-6 weeks after surgery. Results: The mean patient age was 9.1 years (3.5-16). The mean operative and console times were 178 (122-250) and 129 (96-193) minutes, respectively. The Jackson-Pratt drain was removed after a mean of 1.8 days (1-4). The mean hospital stay was 2.4 days (1-4.5). There were no complications. Mean follow up was 16 months (12-24 months). All patients had complete resolution of symptoms. Hydronephrosis either completely resolved or significantly decreased in all cases. In cases without complete resolution of hydronephrosis, 99m Tc-MAG-3 diuretic renography showed preservation of renal function without obstruction. Conclusions: Robot-assisted laparoscopic pyeloplasty can be safely performed without internal indwelling stent drainage. In children, this avoids the need for additional anesthesia and stent-related morbidity.

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Section: Discussionmentioning

confidence: 99%

Stentless pediatric robotic pyeloplasty

Rodríguez¹,

Rich²,

Swana³

2012

Therapeutic Advances in Urology

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“…Since LP started to get popularized within the last 2 decades, the surgical steps of the procedure have been the subject of numerous publications [6,7,8,9,10]. Of the surgical steps that affects the operative time and success, stenting is another critical step of the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Mandhani et al [6] compared the 2 different approaches of stenting during LP. Antegrade stenting was successfully performed in 23 out of 24 patients in a mean time of 5.2 min, while the time required for retrograde stenting was 39.3 min.…”

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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“…Complications due to JJ stenting that occur during insertion or due to the presence of the JJ stent in situ are described in the literature. [16] Mandhani et al [5] recognized inadvertent injury to the ureterovesical junction.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic antegrade JJ stenting diminishes the need for an additional procedure and decreases the risk of complications, such as the stent being cut or migrating upward. [5] Moreover, antegrade JJ stenting provides better anatomical delineation and dissection around the ureteropelvic junction (UPJ) since the renal pelvis remains distended. However, Papalia et al [6] reported that retrograde JJ stenting was a favorable technique with a high success rate.…”

Section: Introductionmentioning

confidence: 99%

Does antegrade JJ stenting affect the total operative time during laparoscopic pyeloplasty?

Bolat¹,

Çınar²,

Akdeniz³

2017

Turkish Journal of Urology

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Objective: We aimed to show the effect of retrograde JJ stenting and intraoperative antegrade JJ stenting techniques on operative time in patients who underwent laparoscopic pyeloplasty. Material and methods:A total of 34 patients were retrospectively investigated (15 male and 19 female) with ureteropelvic junction obstruction. Of the patients stentized under local anesthesia preoperatively, as a part of surgery, 15 were retrogradely stentized at the beginning of the procedure (Group 1), and 19 were antegradely stentized during the procedure (Group 2). A transperitoneal dismembered pyeloplasty technique was performed in all patients. The two groups were retrospectively compared in terms of complications, the mean total operative time, and the mean stenting times. Results:The mean ages of the patients were 31.5±15.5 and 33.2±15.5 years (p=0.09), and the mean body mass indexes were 25.8±5.6 and 26.2.3±8.4 kg/m 2 in Group 1 and Group 2, respectively. The mean total operative times were 128.9±38.9 min and 112.7±21.9 min (p= 0.04); the mean stenting times were 12.6±5.4 min and 3.5±2.4 min (p= 0.02); and the mean rates of catheterization-to-total surgery times were 0.1 and 0.03 (p= 0.01) in Group 1 and 2, respectively. The mean hospital stays and the mean anastomosis times were similar between the two groups (p>0.05). Conclusion:Antegrade JJ stenting during laparoscopic pyeloplasty significantly decreased the total operative time.

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Is Antegrade Stenting Superior to Retrograde Stenting in Laparoscopic Pyeloplasty?

Cited by 70 publications

References 11 publications

Stentless pediatric robotic pyeloplasty

Stentless pediatric robotic pyeloplasty

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

Does antegrade JJ stenting affect the total operative time during laparoscopic pyeloplasty?

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