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Comparison of Drainage Methods After Pyeloplasty in Children: A 14-Year Study

Xiangpan Kong1,2, Zhenpeng Li1,2, Mujie Li1,2

  • 1Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.

Frontiers in Pediatrics
|December 30, 2021
PubMed

Insights

Trans-uretero-cystic external urethral stent (TEUS) is not recommended for drainage after laparoscopic pyeloplasty due to higher recurrence rates and complications. Double-J stent and percutaneous trans-anastomotic stent show better outcomes.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Congenital ureteropelvic junction obstruction (UPJO) is a common cause of hydronephrosis in children.
  • Laparoscopic pyeloplasty is a standard surgical treatment for UPJO.
  • Postoperative drainage methods are crucial for successful outcomes.

Purpose of the Study:

  • To evaluate and compare the efficacy of different postoperative drainage methods after laparoscopic pyeloplasty.
  • To identify the optimal drainage strategy to minimize complications and recurrence.

Main Methods:

  • Retrospective review of 838 pediatric patients undergoing laparoscopic pyeloplasty for UPJO (2007-2020).
  • Analysis of demographics, perioperative data, and long-term follow-up outcomes.
  • Comparison of three drainage methods: double-J stent, percutaneous trans-anastomotic (PU) stent, and trans-uretero-cystic external urethral stent (TEUS).

Main Results:

  • No significant difference in preoperative demographics among the drainage groups.
  • TEUS group showed a statistically higher incidence of reoperations and recurrences (3.19%) compared to DJ (0.36%) and PU (0.93%) groups.
  • Recurrences in the TEUS group were associated with stenosis and iatrogenic valvular formation.

Conclusions:

  • Not all drainage methods are equally suitable for laparoscopic pyeloplasty.
  • TEUS is not recommended due to its association with increased complications and recurrence rates.
  • DJ and PU stents appear to be safer and more effective drainage options.

Keywords:
drainage methodshydronephrosisoutcomespyeloplastyureteropelvic junction obstruction

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