Surgery versus non-surgical management for unilateral ureteric-pelvic junction obstruction in newborns and infants less than two years of age

Weitz, Marcus; Portz, Suniva; Laube, Guido F.; Meerpohl, Joerg J; Bassler, Dirk

doi:10.1002/14651858.cd010716.pub2

Cited by 14 publications

(8 citation statements)

References 50 publications

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“…Even if the safety and efficacy of unstented pyeloplasty were reported, the majority of surgeons prefer to place a trans anastomotic stent to drain urine. This could help to release the stress on the newly formed anastomosis ( 23 ). The DJ stent and external stent were the main management of anastomosis drainage after pyeloplasty, and each measure had its advantages and disadvantages ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

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

Meng

Gan

et al. 2022

Front. Pediatr.

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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.

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Section: Discussionmentioning

confidence: 99%

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

Meng

Gan

et al. 2022

Front. Pediatr.

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“…Surgical intervention for UPJO is aimed at removing of obstruction segment, relieving of pain, and preserving of renal function ( 4 , 24 ). There are many indices that have been used to identify the need for surgery, such as SFU grade 3 or 4, continued expansion of the renal pelvis collection system, a renal cortex <5 mm, a single kidney with decrease in GFR, and symptom of pain ( 25 , 26 ). Regrettably, there has been no reliable criterion that could be used in risk stratification and decision making with UPJO.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Efficacy of Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction via Retroperitoneal and Transperitoneal Approaches

Chen

et al. 2021

Front. Pediatr.

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Objective: This study aimed to evaluate the clinical efficacy of laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) via retroperitoneal and transperitoneal approaches.Method: A systematic literature search on keywords was undertaken using PubMed, Cochrane Library, Embase, China Nation Knowledge (CNKI), and Wanfang. The eligible literature was screened according to inclusion and exclusion criteria. Meta-analysis was performed by using RevMan 5.0 software.Results: According to the inclusion and exclusion criteria, 12 studies were identified with a total of 777 patients. Four hundred eight patients were treated with retroperitoneal laparoscopic pyeloplasty (RLP), and 368 patients were treated with transperitoneal laparoscopic pyeloplasty (TLP). The meta-analysis results showed that the two approaches were similar in terms of presence of postoperative hospital stay, postoperative complication, the rate of conversion, and recurrence (p > 0.05). The operative time in the TLP group was significantly shorter than the RLP group (MD = 16.6; 95% CI, 3.40–29.80; p = 0.01). The duration of drainage was significantly shorter (MD = −1.06; 95% CI, −1.92 to −0.19; p = 0.02), and the score of postoperative visual analog score (VAS) was significantly lower in the RLP group than in the TLP group (MD = −0.52; 95% CI, −0.96 to −0.08; p = 0.02).Conclusion: Both approaches have good success rates and low postoperative complication rates. RLP provides a shorter duration of drainage and lower VAS score, but it takes more operative time than TLP.

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“…In 2016, the Cochrane review by Weitz et al (19) aimed at evaluating the effects of surgical vs. non-surgical management in newborns and children < 2 years of age with unilateral UPJS. Unfortunately, the sample size was too small and the follow-up time too short to deliver conclusive results as to which group did better longer term, had fewer complications, and had better quality of life.…”

Section: Uretero-pelvic Junction Stenosis (Upjs)mentioning

confidence: 99%

Clinical Outcome of Children With Antenatally Diagnosed Hydronephrosis

et al. 2019

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Fetal renal pelvis dilation is a common condition, which is observed in 1–4. 5% of pregnancies. In many cases, this finding resolves spontaneously. However, sometimes it may be a signal of significant urinary tract pathologies. The main abnormalities found after birth are uretero-pelvic junction stenosis, primary vesicoureteral reflux, megaureter, duplex kidneys, and posterior urethral valves, with uretero-pelvic junction stenosis and primary vesicoureteral reflux accounting for most of the cases. Diagnosis, management, and prognosis at short and longer term of these conditions will be reviewed in this article.

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Surgery versus non-surgical management for unilateral ureteric-pelvic junction obstruction in newborns and infants less than two years of age

Abstract: Surgery versus non-surgical management for unilateral ureteric-pelvic junction obstruction in newborns and infants less than two years of age.

Cited by 14 publications

References 50 publications

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

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

Meta-Analysis of the Efficacy of Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction via Retroperitoneal and Transperitoneal Approaches

Clinical Outcome of Children With Antenatally Diagnosed Hydronephrosis

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