Beneficios y desventajas de pielostomía o catéter doble J en niño operados de pieloplastia
Fecha
2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Objetivos: En edad pediátrica la Estenosis de la unión pieloureteral con dilatación
piélica de moderado a grave se trata con pieloplastia de Anderson Hynes. La
derivación urinaria transanastomótica luego de la cirugía se realiza con catéter
doble j o por pielostomía, existiendo controversia sobre cuál es mejor. Metodología:
Con el proposito de establecer diferencias en beneficios y desventajas entre
pielostomía y Catéter Doble J en niños se desarrolló un estudio de cohorte en el que
se incluyeron de manera no probabilística pacientes pediátricos que fueron
intervenidos quirúrgicamente entre el 1 de enero de 2014 al 31 de diciembre de
2018 en el hospital de niños Roberto Gilbert Elizalde Guayaquil-Ecuador por
pieloplastia de Anderson Hynes debido a estenosis de la unión pielocalicial.
Resultados: No hubo desventajas estadísticamente significativas en complicaciones
posoperatoria entre el catéter doble j y pielostomía. Los beneficios de pielostomía
se asocia con menor ingreso a quirófano post-pieloplastia (100% vs 0%) menor uso
de sonda uretral (3.4% vs 100%) menor tiempo de permanencia de dispositivo
urinario (5± 4 días vs 29 ± 16 días P 0,000). Por el contrario, el catéter doble J tiene
menor estancia hospitalaria que la pielostomía (4 ± 3 días vs. 8 ± 6 días; P 0.000).
Conclusión: No hay complicaciones posquirúrgicas que sea mayor con un
dispositivo urinario que con el otro y los beneficios son favorables con relación a
la pielostomía en comparación con el catéter doble j para el manejo de la
pieloplastia de Anderson Hynes por estenosis pieloureteral en niños.
Palabras clave: Dilatación Piélica. Tratamiento. Cirugía. Pieloplastia.
Pielostomía.
Objective: In pediatric age, stenosis of the pyeloureteral junction with moderate to severe pelvic dilation is treated with Anderson Hynes pyeloplasty. Transanastomotic urinary diversion after surgery is performed with a double J catheter or pyelostomy, with controversy over which is better. Methodology: In order to establish differences in benefits and disadvantages between pyelostomy and Double J Catheter in children, a cohort study was developed in which nonprobabilistic pediatric patients who were surgically operated between January 1, 2014 and 31 were included. December 2018 at the Roberto Gilbert Guayaquil- Ecuador Hospital due to Anderson Hynes pyeloplasty due to pielocalicial junction stenosis. Results: There where no statistically significant disadvanteges in postoperative complications between the double j catheter and pyelostomy. The benefits of pyelostomy are associated with less admission to the postpyeloplasty operating room (100 vs 0%), less time spend in the urinary device (3.4% vs 100%), shorter time spend urinay device (5± 4 days vs 29 ± 16 days P 0,000). On the contrary, the double j catheter has a shorter hospital stay than pyelostomy (4 ± 3 days vs. 8 ± 6 days; P 0.000). Conclusion: there are no post-surgical complications that are greater with one urinary device than with the other and benefits are favorable in relation to pyelostomy compared to the double j catheter for the management of Anderson Hynes pyeloplasty due to pyeloureteral stenosis in children.
Objective: In pediatric age, stenosis of the pyeloureteral junction with moderate to severe pelvic dilation is treated with Anderson Hynes pyeloplasty. Transanastomotic urinary diversion after surgery is performed with a double J catheter or pyelostomy, with controversy over which is better. Methodology: In order to establish differences in benefits and disadvantages between pyelostomy and Double J Catheter in children, a cohort study was developed in which nonprobabilistic pediatric patients who were surgically operated between January 1, 2014 and 31 were included. December 2018 at the Roberto Gilbert Guayaquil- Ecuador Hospital due to Anderson Hynes pyeloplasty due to pielocalicial junction stenosis. Results: There where no statistically significant disadvanteges in postoperative complications between the double j catheter and pyelostomy. The benefits of pyelostomy are associated with less admission to the postpyeloplasty operating room (100 vs 0%), less time spend in the urinary device (3.4% vs 100%), shorter time spend urinay device (5± 4 days vs 29 ± 16 days P 0,000). On the contrary, the double j catheter has a shorter hospital stay than pyelostomy (4 ± 3 days vs. 8 ± 6 days; P 0.000). Conclusion: there are no post-surgical complications that are greater with one urinary device than with the other and benefits are favorable in relation to pyelostomy compared to the double j catheter for the management of Anderson Hynes pyeloplasty due to pyeloureteral stenosis in children.
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DILATACION PIELICA, TRATAMIENTO, PIELOPLASTIA, PIELOSTOMIA, HOSPITAL DE NIÑOS DR. ROBERTO GILBERT ELIZALDE, CANTON GUAYAQUIL, ECUADOR, CATETER DOBLE J, PEDIATRIA