Comparison of outcomes between 2 week versus 4 week stenting in pediatric pyeloplasty—A single centre observational study

Abstract

Objective: To compare the surgical outcomes, improvement in renal function and complications between early stent removal (2 weeks) and late stent removal (4 weeks) after pediatric open pyeloplasty. Methods: A total of 72 open pyeloplasty were included in the study. Forty-three underwent late stent removal (Group 1) and 29 underwent early stent removal (Group 2). Pre-operative and post-operative follow-up data were compared to see the effect of early stent removal on the postoperative drainage pattern at 6 months after surgery and improvement in split function of affected kidney. The complications between the two groups were also compared. Results: Both the groups were matched with respect to age, sex, side and antero-posterior diameter of pelvis. Pre-operative mean split function in Group 1 was 42% (26%–54%) while it was 39% (19%–42%) in Group 2 (p=0.37). Postoperative improvement in drainage pattern was seen in 69 out of 72 (96%) patients, 41 out of 43 (95%) in Group 1 and 28 out of 29 (97%) in Group 2. Improvement in split function occurred in 35 of 38 (97%) in Group 1 and 23 of 26 (88%) patients in Group 2 (p=0.51). Complications were seen in nine out of 72 (12.5%) patients. Incidence of complication in Group 1 was 16% (7/43) and Group 2 was 7% (2/29), and relative risk was 2.36. Conclusion: A shorter duration of double J stenting is as effective as a longer stenting period in terms of surgical success outcomes and improvement in split renal function along with a decreased risk of stent related complications.

Keywords

• Pelvi-ureteric junction obstruction
• Anderson-Hynes pyeloplasty
• Double J stenting
• Outcomes