One‐ vs 4‐week stent placement after laparoscopic and robot‐assisted pyeloplasty: results of a prospective randomised single‐centre study. (June 2014)

• Record Type: Journal Article
• Authors: Danuser, H.; Germann, C.; Pelzer, N.; Rühle, A.; Stucki, P.; Mattei, A.
• Is Part Of: BJU international. Volume 113:Number 6(2014:Jun.)
• Page Start: 931
• Page End: 935
• Publication Date: 2014-06
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12652
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12652-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine whether 1‐week stenting of the pelvi‐ureteric anastomosis of laparoscopic or robot‐assisted pyeloplasty is as effective as 4‐week stenting, based on their respective success rates.</p> </sec> <sec id="bju12652-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p>A total of 100 patients with pelvi‐ureteric junction obstruction were treated by Anderson‐Hynes pyeloplasty and the anastomosis was stented using a 6‐F JJ catheter for either 1 week (1W series) or 4 weeks (4W series), based on a randomisation protocol. Postoperative follow‐up was performed at 3 months using intravenous urography (IVU), at 6 months using diuretic renography and at 1, 3 and 5 years using ultrasonography. Statistical analysis was performed using a one‐sided <italic>Z</italic>‐test, Pearsons's chi‐squared test and a Wilcoxon rank sum test.</p> </sec> <sec id="bju12652-sec-0003" sec-type="section"> <title>Results</title> <p>The primary outcome measure, success rate, which was defined as no obstruction on IVU and diuretic renography, was 100% in the 1W series and not inferior to the success rate of 98% in the 4W series (<italic>P</italic> = 0.006). The following secondary outcome measures were not significantly different between the 1W and the 4W series with regard to residual symptoms (10 vs 6%; <italic>P</italic> = 0.48), rate of complications (4 vs 6%; <italic>P</italic> = 0.65), need for synchronous robot‐assisted pyelolithotomy (4 vs 8%; <italic>P</italic> = 0.47), improvement in split renal function (1 vs 0%; <italic>P</italic> = 0.59) and duration of surgery (200 vs 192 min; <italic>P</italic> = 0.87). Only length of hospital stay was significantly different; this was shorter in the 1W series (5 vs 6 days; <italic>P</italic> = 0.01).</p> </sec> <sec id="bju12652-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Stenting of the pelvi‐ureteric anastomosis after laparoscopic or robot‐assisted pyeloplasty for 1 week is as effective as stenting for 4 weeks. Both procedures, laparoscopic or robot‐assisted pyeloplasty have an excellent success rate.</p> </sec> </abstract>