Study of Effectiveness of Double J (D-J) Stent and Transanastomotic BMI Tube Stent in Anderson Hynes (A-H) Pyeloplasty for The Management of Unilateral Pelvi-Ureteric Junction (PUJ) Obstruction in Children

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dc.contributor.authorPaul, Swapan Kumaren_US
dc.contributor.authorIslam, Rakibulen_US
dc.contributor.authorGhosh, Paritosh Kumaren_US
dc.contributor.authorBiswas, Prosanto Kumaren_US
dc.contributor.authorAli, Md. Ayuben_US
dc.contributor.authorBiswas, Ipsitaen_US
dc.date.accessioned2023-07-21T11:26:09Z
dc.date.available2023-07-21T11:26:09Z
dc.date.issued2022-12
dc.description.abstractBackground: Hydronephrosis is a major urological health problem in children. Pelviretic junction (PUJ) obstruction is common among the congenital causes of hydronephrosis. A-H pyeploplasty is the most popular and common technique. There are different modalities of using trans-anastomotic stent in A-H pyeloplasty. Some surgeons use external drainage like nephrostomy tube, pyelostomy tube or trans-anastomotic stent and others use internal drainage D-J stent. In this study, D-J stent and BMI feeding tube were used for trans anastomotic drainage. We analyzed the data to find out which method of stenting in A-H pyeloplasty is more effective and safer and also to reduce the morbidity by reducing stent related complications.Material & Methods:A prospective interventional study was conducted in the faculty of Paediatric Surgery inBangladesh Shishu Hospital and Institute during the period from January 2016 to December 2019. A total of 60 patients under 12 years of age were included in this study were diagnosed as uni-lateral hydronephrosis for PUJ obstruction. Patients were divided into two groups by random lottery method and all patients underwent A-H pyeloplasty under general anaesthesia (G-A). In group-A, A-H pyeloplasty were done with using Double (D-J) stent and in group-B, 5Fr or 6Fr BMI tube were used as trans-anastomotic drainage. Patients were followed up after 2 weeks of operation, at 3 months and them at 6 months. The variables of the post-operative follow up study were patency of anastomosis, urinary tract infection, (UTI), urinary leakage and post-operative hospital stay and statistical analysis were done.Results:In group-A (30 cases), Anderson-Hynes pyeloplasty were done using D-J stent and in group-B (30 cases) with using trans-anastomotic BMI tube. In group-A most (73.33%) patients were below 5 years and in group-B 48 patients (80%) were below 5 years. In group-A mean age was 3.57+ 3.11 years and in group-B mean age was 3.31+3.21 years. There is no statistically significant difference in age distribution. In group-A left kidney were involved 66.7% cases and in group B in 80% cases left kidney were involved. In the early post-operative period, no urinary obstruction in group-A, however in 20% cases developed urinary obstruction in group-B but that was not statistically significant. In group-B continuous urinary leakage through drain tube was for 0-15 days but in group-B leakage was only or 0-1 day. It was statistically significant (p=0.037). In group-A, range of time of removal of drain tube was 4 days but in group-B range was 8-27 days. It was statistically significant (p=0.0001). Hospital stay in group-A was 4-8 days and in group B 9-29 days. It was also statistically significant (p=0.0001).Conclusion: In A-H pyeloplasty, morbidity of the patients can be reduced by using D-J stent which is more effective and safer. We found definite statistically significant difference in terms of urinary leakage, post-operative UTI, and hospital stay.en_US
dc.identifier.affiliationsAssociate Professor and Head, Department of Paediatric Neurosurgery, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka. Email: dr.s.kpaul1234@gmail.com Orcid ID: 0000-0002-0620-3509.en_US
dc.identifier.affiliationsRegistrar in charge, Department of Paediatric Neurosurgery, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka. Email: drhiroksh2@gmail.com Orcid ID: 0000-0002-4841-6561en_US
dc.identifier.affiliationsAssistant professor, Department of cardiology, Kustia Medical College, Kustia. Email: paritoshhssmc@gmail.com Orcid ID: 0000-0002-3765-0109en_US
dc.identifier.affiliationsRegistrar in charge, Department of Paediatric Burn & Reconstructive Surgery, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka. Email: dr.pkb31@gmail.com Orcid ID: 0000-0003-3282-2183en_US
dc.identifier.affiliationsAssociate Professor, Department of Paediatric Urology, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka. Email: Ayub.alidhs@gmail.com Orcid ID: 0000-0003-0734-4263en_US
dc.identifier.affiliationsAssociate Professor and Head, Department of Paediatric Urology, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka. Email: biswasipsita@yahoo.com Orcid ID: 0000-0002-7272-701Xen_US
dc.identifier.citationPaul Swapan Kumar, Islam Rakibul, Ghosh Paritosh Kumar, Biswas Prosanto Kumar, Ali Md. Ayub, Biswas Ipsita. Study of Effectiveness of Double J (D-J) Stent and Transanastomotic BMI Tube Stent in Anderson Hynes (A-H) Pyeloplasty for The Management of Unilateral Pelvi-Ureteric Junction (PUJ) Obstruction in Children. Annals of International Medical and Dental Research. 2022 Dec; 8(6): 97-104en_US
dc.identifier.issn2395-2822
dc.identifier.issn2395-2814
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/220073
dc.languageenen_US
dc.publisherScholars Publisheren_US
dc.relation.issuenumber6en_US
dc.relation.volume8en_US
dc.source.urihttps://doi.org/10.53339/aimdr.2022.8.6.13en_US
dc.subjectHydronephrosisen_US
dc.subjectUni-lateral PUJ obstructionen_US
dc.subjectA-H pyeloplastyen_US
dc.subjectstenting.en_US
dc.titleStudy of Effectiveness of Double J (D-J) Stent and Transanastomotic BMI Tube Stent in Anderson Hynes (A-H) Pyeloplasty for The Management of Unilateral Pelvi-Ureteric Junction (PUJ) Obstruction in Childrenen_US
dc.typeJournal Articleen_US
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