[Pyeloplasty without intrarenal stent in pediatric patients]

Area of Science:

• Pediatric Urology
• Surgical Techniques
• Endourology

Context:

• Open dismembered pyeloplasty remains a common procedure for pediatric pyeloureteral stenosis.
• Advances in minimally invasive surgery have not entirely replaced open techniques, particularly in younger children.
• Intrarenal stenting is a traditional component of pyeloplasty, aimed at facilitating urine drainage and healing.

Purpose:

• To evaluate the efficacy and safety of minimally invasive open pyeloplasty without intrarenal stents in pediatric patients.
• To present surgical outcomes and complication rates for this modified technique.
• To determine if omitting intrarenal stents impacts the success of open pyeloplasty.

Summary:

• A retrospective review of 310 pediatric patients (223 boys, 87 girls) who underwent open pyeloplasty without intrarenal stents between 1992 and 2009.
• The procedure involved a small flank incision (2-2.5 cm), with an extrarenal drain and bladder catheter.
• Success rate was 97.8% (312/319 pyeloplasties) with a mean follow-up of 6.7 years; 2.2% required reoperation.

Impact:

• Minimally invasive open pyeloplasty without intrarenal stents is a safe and effective alternative for treating pyeloureteral stenosis in children.
• This approach can achieve high success rates comparable to traditional methods, potentially reducing morbidity associated with stents.
• The findings support the adoption of stentless open pyeloplasty in pediatric urology centers.