Abstract
Objective: To summarize our experiences with drainage methods after laparoscopic pyeloplasty with a 14-year study.Methods: We reviewed the data of the 838 children operated on for hydronephrosis due to congenital ureteropelvic junction obstruction (UPJO) between July 2007 and July 2020. Patients' demographics, perioperative details, postoperative drainage stents [including double-J stent, percutaneous trans-anastomotic (PU) stent, and trans-uretero-cystic external urethral stent (TEUS)], complications, hospital stay, and long-term follow-up outcomes were analyzed. Long-term follow-up was performed by outpatient visits and telephone follow-up. Moreover, we reviewed the details of nine cases of recurrence after laparoscopic pyeloplasty.Results: Comparison of preoperative general data among the three groups indicated that there was no statistical difference in age, gender, and surgical side of the three groups. Statistical differences were found in the incidence of postoperative complications from the three postoperative drainage method groups, especially the incidence of reoperations (p < 0.01): there were six cases (3.19%) of recurrences in the TEUS group, two cases (0.36%) in the DJ group, and one case (0.93%) in the PU group. In the six recurrent cases from the TEUS group, four cases (44.4%) were found to have stenosis, and two cases (22.2%) have iatrogenic valvular formation.Conclusion: Not all three types of drainage methods are suitable for drainage after pyeloplasty. Based on our findings, TEUS is not recommended.
Highlights
Congenital ureteropelvic junction obstruction (UPJO) is one of the most commonly encountered abnormalities that are responsible for persistent hydronephrosis in children [1]
We used the trans-uretero-cystic external urethral stent (TEUS) approach to solve the problems caused by the DJ stent and percutaneous transanastomotic (PU) stent; in the previous research [11], we proved it to be safe and effective by comparing it with the DJ stent, but there is a lack of verification of long-term follow-up results in the study
After a long-term postoperative follow-up work, we found some abnormal results, which made us question the safety of this new drainage method
Summary
Congenital ureteropelvic junction obstruction (UPJO) is one of the most commonly encountered abnormalities that are responsible for persistent hydronephrosis in children [1]. The classic option of treatment for UPJO is pyeloplasty. Since the first descriptions of laparoscopic pyeloplasty (LP) in 1993 by Schlussel [2] and in 1995 by Peters [3], LP has become the gold standard in the treatment. Experiences With Laparoscopic Pyeloplasty in Children With UPJO of UPJO, with its safety and minimal invasiveness. Surgeons will choose to use a drainage stent after pyeloplasty; which drainage method is the best choice is still quite controversial [4, 5]. The ideal drainage method should be effective while being minimally invasive and safe. We used the trans-uretero-cystic external urethral stent (TEUS) approach to solve the problems caused by the DJ stent and PU stent; in the previous research [11], we proved it to be safe and effective by comparing it with the DJ stent, but there is a lack of verification of long-term follow-up results in the study
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
