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Comparison of external stents and DJ stents techniques for pediatric pyeloplasty: A systematic review and
Chunyang Meng1, Lijian Gan1, Kangsen Li1
1Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, China.
Insights
This study compared external stents and Double J stents for pediatric pyeloplasty. Results showed no significant differences in outcomes, though external stents may reduce operative time in robot-assisted procedures.
Area of Science:
- Urology
- Pediatric Surgery
- Medical Device Comparison
Background:
- Pediatric pyeloplasty is a common procedure for ureteropelvic junction obstruction.
- Stent placement is crucial for post-operative healing and success.
- External stents and Double J (DJ) stents are commonly used, each with potential benefits and drawbacks.
Purpose of the Study:
- To systematically review and compare the efficacy and safety of external stents versus Double J stents in pediatric pyeloplasty.
- To analyze key outcomes including operative time, success rates, hospital stay, and complications.
Main Methods:
- A systematic review and meta-analysis was conducted following PRISMA guidelines.
- Eleven studies involving 1,758 pediatric patients undergoing pyeloplasty were included.
- Data were extracted and analyzed to compare outcomes between external stent and DJ stent groups.
Main Results:
- No statistically significant differences were found between external stents and DJ stents regarding operative time, success rate, hospital stay, or complication rates.
- Subgroup analysis indicated a potentially shorter operative time for external stents in robot-assisted laparoscopic pyeloplasty (P=0.032).
Conclusions:
- External stents and DJ stents demonstrate comparable efficacy and safety profiles for pediatric pyeloplasty.
- External stents may offer a benefit in reducing operative time for robot-assisted procedures, warranting further investigation.
- Additional research is needed to confirm these findings due to study limitations.
Objective:
To evaluate and compare the efficacy and safety between an external stent and a Double J stent for pediatric Pyeloplasty.
Methods:
Through 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).
Results:
Eleven 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).
Conclusions:
There 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 Registration:
This systematic review has been registered on PROSPERO, the registration ID is CRD42021274087.
