Kidney internal splint/stent (KISS) catheter revisited for pediatric pyeloplasty.

OBJECTIVES

To review our experience using the Kidney Internal Splint/Stent (KISS) (Cook Medical, Bloomington, IN) to provide drainage after pyeloplasty. The KISS combines the attributes of nephrostomy tube diversion and anastomotic stent in a single tube. Since its initial description in 1993, additional reports on its use are limited.

METHODS

We retrospectively reviewed charts of patients who underwent pyeloplasty by single surgeon, with simultaneous placement of KISS stent from 2003 to 2008. Preoperative and postoperative renal function and t((1/2)) times of the affected renal unit were determined by nuclear renography. Nephrostograms were performed 10 days after surgery. Complications from the use of KISS catheter including premature dislodgement or infection were noted.

RESULTS

We performed 59 pyeloplasties with KISS stent placement in 57 patients. Mean age of patients was 23 months with follow-up of 32 months (range 6-69). Median preoperative and postoperative renal function was 47% and 49%, respectively. Median preoperative and postoperative t(1/2) times were 80 and 12 minutes, respectively (P = .001). Nephrostograms did not reveal leak in any patient. Unintentional removal of KISS stent did not occur in any patient. Postoperative febrile UTI occurred in 2 patients while the KISS stent was in place.

CONCLUSIONS

KISS stents can be used safely and effectively in a wide variety of clinical situations surrounding pyeloplasty. The KISS catheter was well tolerated by the patients in our series. The KISS stent offers the combined advantages of nephrostomy tube and internal stent while obviating the second anesthetic that would be necessary with an internal stent.