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A comparison between short- and long-term D-J stent in Anderson–Hynes pyeloplasty for pelvi-ureteric junction obstruction

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Abstract

Purpose

A double-J (D-J) stent is usually kept in situ during Anderson–Hynes (A–H) pyeloplasty for pelvi-ureteric junction (PUJ) obstruction. The aim of the study is to determine whether early removal of D-J stent is better than long-term stenting.

Methods

In this prospective comparative study, conducted from January 2018 to April 2019 in Chittagong Medical College Hospital, patients with PUJ obstruction, age less than 12 years, were divided into group A (long-term stenting) and group B (short-term stenting) by simple randomization. Main outcome variables were urinary tract infection (UTI), stent colonization, encrustation, renal cortical thickness, differential renal function (DRF), glomerular filtration rate (GFR), and flow rate in DTPA renogram.

Results

There were 31 patients in each group. Median age was 5 years (IQR: 2.3 to 7 years) and male to female ratio was 2.1:1. Frequency of post-operative UTI and stent colonization were significantly higher in group A than group B (p < 0.001). All the patients of both groups had similar improvement in renal cortical thickness, DRF, GFR, and flow rate. The study was potentially limited by its small sample size and high median age (5 years).

Conclusion

Early removal of D-J stent had lower incidence of UTI, stent colonization, encrustation, and stent migration.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Chittagong Medical College, 1 KB Fazlul Kader Road, Chittagong, 4203, Bangladesh

    Md. Sharif Imam, Md. Abdullah Al Farooq, Md. Khurshid Alam Sarwar, Tanvir Kabir Chowdhury, Rajib Khastagir, Md. Golam Habib & Adnan Walid

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  1. Md. Sharif Imam
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  2. Md. Abdullah Al Farooq
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  3. Md. Khurshid Alam Sarwar
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  4. Tanvir Kabir Chowdhury
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  5. Rajib Khastagir
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  6. Md. Golam Habib
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  7. Adnan Walid
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Contributions

Conceptualization: MSI; methodology: TKC; formal analysis and investigation: MSI, AW, and MGH; writing—original draft preparation: MSI and TKC; writing—review and editing: RK and MKAS; supervision: MAAF and MKAS.

Corresponding author

Correspondence to Tanvir Kabir Chowdhury.

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Conflict of interest

The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be constructed as potential conflict of interest.

Ethical approval

The study was granted ethical approval by the Ethical Committee of Chittagong Medical College (Ref. CMC/PG/2018/410).

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Imam, M.S., Al Farooq, M.A., Sarwar, M.K.A. et al. A comparison between short- and long-term D-J stent in Anderson–Hynes pyeloplasty for pelvi-ureteric junction obstruction. Pediatr Surg Int 36, 1363–1370 (2020). https://doi.org/10.1007/s00383-020-04734-9

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