Pediatric pyeloplasty: Intubated vs nonintubated

Abstract

Objectives: Despite continued controversy regarding the optimal method of urinary diversion after pyeloplasty, we have treated majority of our patients without any tubes or stents. The present study is done to assess the benefits of performing nonintubated pyeloplasty in children. Materials and Methods: Thirty consecutive cases of pelviureteric junction obstruction were enrolled in the study from 1998 to 2004 (5.6 years). Six patients underwent nephrectomy and were excluded from the study. Twenty-four patients underwent pyeloplasty performed by a single surgeon; 20 were nonintubated pyeloplasties, other four were intubated. Postoperative complications and length of hospital stay were assessed. Results: The intubated group had higher incidence of UTI and persistence of partial mechanical obstruction postoperatively on radio-nucleotide scans. They also had a significantly longer hospital stay as compared with the nonintubated group. Conclusions: Nonintubated pyeloplasty in children is safe, cost effective and associated with fewer complications. A stent and a nephrostomy tube appear to be unnecessary in the routine pyeloplasty.