Title: Study of Method of Proper Placement of DJ Stent during Open Pyeloplasty in Children for Uretero Pelvic Junction Obstruction, Without C-Arm
Author: Dr Nirmal Bhaskar
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.107
Abstract
Introduction: Uretero Pelvic junction (UPJ) obstruction is defined as an obstruction of the flow of urine from the renal pelvis to the proximal ureter. Pyeloplasty is the treatment. Proper placement of DJ stent is usually confirmed with C –Arm.
Objective: Study of Method of Proper Placement of DJ Stent During Open Pyeloplasty in Children for UreteroPelvic Junction Obstruction, Without C-Arm.
Materials and Methods: This is a prospective study of 3 years duration. Total there were 20 children. Only Anderson–Hynes dismembered pyeloplasty included in the study. C-Arm is not used. Our method involved opening renal pelvis and UPJ obstruction is resected. 6FG infant feeding tube is introduced to ureter and 15cc Normal saline injected. Then DJ stent is put via opening at upper end of ureter. Now apply pressure on bladder. If saline is coming through the upper end we can confirm the position of DJ stent.
Result: Of the total 20 cases, we put DJ stent in 17 cases. In 3 cases there was difficulty in introducing DJ stent and saline didn’t come back. All the 17 cases had successful removal of DJ stent with cystoscope.
Conclusion: Our study shows that the above method is a good option for confirming the position of DJ stent, without C- Arm and radiation. All DJ stents can be removed by cystoscopy. It can avoid unnecessary exploration of kidney and ureter to remove stent.
Keywords: Open Pyeloplasty, Uretero Pelvic Junction Obstruction, DJ stent, C-Arm, Cystoscopy , Anderson Hynes Pyeloplasty