Objectives: To asses the safety, complication and results of open pyeloplasty with DJ stenting versus feeding tube as a nephrostomy cum stent.
Methodology: A retrospective cohort study of 40 cases of open pyeloplasty carried out at Ghulam Mohammad Medical College & Hospital and Red Crescent Hospital, Sukkur, Pakistan from June 2012 to June 2014. Forty patients suffering from PUJO were included in the study. Patients were divided into two groups randomly; Group A comprised of 20 patients who under went open pyeloplasty with DJ stenting while Group B comprised of 20 patients who under went open pyeloplasty with feeding tube as a nephrostomy cum stent.
Results: Out of 40 patients, 30(75%) were male and 10(25%) female. The age ranged from 5 to 45 years (mean 24 years). The cause of obstruction was narrow PUJ in 25(62.5%) patients, high insertion in 5(12.5%), ureteric stricture in 2(5%) and crossing vessels in 8(20%) patients. In Group A, DJ stenting, was retained for 3 month while Group B feeding tube no. 8 was brought out as a nephrostomy cum stent for 15 days. Four (20%) patients had stitch abscess in Group B as compared to Group A in which stich abcess occurred in 2(10%) cases. One case in Group B had anastomotic leakage while 3(15%) in Group A were lost to follow up. Hospital stay was greater in group B as compared to Group A. There was significant difference between two groups (P=0.026) in terms of cost, mean hospital stay, complication and follow up.
Conclusion: Open pyeloplasty with feeding tube as a nephrostomy cum stent is cost effective surgery and has least post operative complication as compared to to DJ stenting due to greater lost follow up in open pyeloplasty with DJ stenting.
PUJO and Open Pyeloplasty, DJ stenting versus feeding tube, nephrostomy