Huang Yitian,Yang Meng,Wen Sheng,et al.Comparison of different drainage methods after ureteroplasty in children[J].Journal of Clinical Pediatric Surgery,,20():247-252.[doi:10.12260/lcxewkzz.2021.03.009]
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Comparison of different drainage methods after ureteroplasty in children

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第20卷 Number: 2021 03 Page: 247-252 Column: 论著 Date of publication: 2021-03-28
Author(s):
Huang Yitian1;  Yang Meng1;  Wen Sheng1; 2; 3; 4;  He Dawei1; 2; 3; 4;  Wei Guanghui1; 2; 3; 4;  Lin Tao1; 2; 3; 4;  Zhang Deying1; 2; 3; 4;  Liu Xing1; 2; 3; 4;  Liu Feng1; 2; 3; 4;  Wu
1. Department of Urology, Children’s Hospital, Chongqing Medical University, Chongqing 400014, China;
2. National Clinical Research Center for Child Health & Disorders, Chongqing 400014, China;
3. Ministry of Education Key Laboratory of Child Develo
Keywords:
Ureteropelvic Junction Obstruction/SU; Hydronephrosis /SU; Drainage; Treatment Outcome
CLC:
R726.9;R692.2
DOI:
10.12260/lcxewkzz.2021.03.009
Abstract:
Objective To explore the optimal drainage method after laparoscopic pelvic ureteroplasty.Methods From January 2016 to December 2019,a total of 165 hydronephrotic children undergoing Anderson-Hynes pyeloplasty under laparoscopic peritoneal approach were divided into two groups.Group A:conventional intraoperative ureter was employed and a double J tube inserted for draining urine from renal pelvis to bladder (double J tube group,n=108);group B:a F4 ureteral stent tube was deposited through renal pelvis to outer urethra to drain urine from renal pelvis to body (stent tube group,n=57).With the indicators of postoperative complications,unplanned reoperation,post-extubation symptoms,postoperative hospital stay and hospitalization costs,the efficacy was evaluated for two different drainage methods after pyeureteroplasty.Results The postoperative follow-up period was until December 2019.The longest follow-up time was 48 months and the shortest 2 months.In stent tube group,there were postoperative infection (n=4),urinary extravasation (n=3) and postoperative hematuria (n=4);in double J tube group,postoperative infection (n=7),urinary extravasation (n=2) and postoperative hematuria (n=2).No significant difference existed in the above indicators (P>0.05).However,the overall complication rate was lower in double J tube group than stent tube group.In stent group,4 cases underwent ureteral stenting for poor ureteral drainage after extubation;ureteroplasty was performed for 2 cases due to recurrent hydronephrosis.In double J tube group,there were postoperative infection (n=4) and double J tube blockage (n=1).All underwent double J tube removal plus ureteral stenting and one case of recurrent hydronephrosis underwent pyeloplasty.The overall unplanned reoperative rate was 10% in stent tube group and 5% in double J tube group and the difference was not statistically significant (P>0.05).In double J tube group,there were lumen blockage (n=1),upward movement of stent tube (n=2) and prolapse of double J tube (n=1).There was no lumen blockage,displacement or shedding in stent tube group and the difference was not statistically significant (P>0.05).In stent tube group,there were abdominal distension & hypertension post-extubation (n=1),abdominal distension (n=8) and anorexia & abdominal pain (n=2).In double J tube group,abdominal pain post-extubation (n=2) and abdominal distension (n=1).The overall adverse reaction rate post-extubation was 19.2% in stent tube group and 2.7% in double J tube group.And the difference was statistically significant (P<0.05).The average hospital stay was (5.8±1.9) days in double J tube group and (8.8±2.3) days in stent tube group.And the difference was statistically significant (P<0.05).Conclusion No inter-group difference existed in the incidence of postoperative complications or the rate of unplanned reoperation.Both drainage methods are effective.However,double J tube is better than stent tube in terms of shorter hospital stay,lower economic costs of children’s family members and a lower incidence of adverse reactions post-extubation.The stent tube group has no blockage,displacement or falling off during tube period and avoids secondary hospitalization.It is recommended for for families with children with inconvenient transportation.

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Memo

收稿日期:2020-03-08。
基金项目:重庆市渝中区基础研究与前沿探索项目（编号：20200151）
通讯作者:华燚,Email:948389879@qq.com

Last Update: 1900-01-01