The Safety and Efficacy of Stentless Pediatric Pyeloplasty: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Introduction: Ureteropelvic junction obstruction (UPJO) is a common cause of hydronephrosis in children and may require surgical correction when conservative management fails. The role of urinary drainage methods, particularly the use of ureteral stents, in pediatric pyeloplasty remains debated. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of stentless pyeloplasty compared to stented procedures in pediatric patients with UPJO.Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024621563). A comprehensive search was conducted in five databases (PubMed, ProQuest, Cochrane, ScienceDirect, and EBSCOhost) up to December 2, 2024. Eligible studies included children (<18 years) undergoing pyeloplasty with or without stent placement. Outcomes assessed included operative time, hospital stay, complication rates, recurrence, and renal function. Data analysis was performed using Review Manager version 5.4. Risk of bias was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool and the Newcastle-Ottawa Scale (NOS).Results: Nine studies (four randomized controlled trials and five retrospective cohort studies) involving 788 pediatric patients (451 stentless, 337 stented) were included. Operative time was similar between groups (mean difference [MD]: –6.03 minutes; 95% confidence interval [CI]: –21.29 to 9.24). Stentless pyeloplasty was associated with a slightly longer hospital stay (MD: 1.00 day; 95% CI: 0.24 to 1.77). No significant differences were observed in complication rates (odds ratio [OR]: 1.16; 95% CI: 0.71–1.89), recurrence (OR: 1.05; 95% CI: 0.36–3.03), or renal function improvement (MD: 0.00; 95% CI: –3.28 to 3.28).Conclusion: Stentless pyeloplasty demonstrates comparable safety and efficacy to stented procedures in the pediatric population. While it may reduce infection risks, the risk of urinary leakage may increase. Individualized surgical decision-making is advised. Further high-quality studies are needed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.037 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.037 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".