Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi‐ureteric junction obstruction?

Chertin, Boris; Rolle, Udo; Farkas, Amicur; Puri, Prem

doi:10.1046/j.1464-410x.2002.02829.x

Cited by 87 publications

(61 citation statements)

References 21 publications

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“…In congruence with earlier findings in the literature, among the infants with neonatal hydronephrosis and children younger than 3 years old, we determined a clear improvement of hydronephrosis and an increment of DRF [13,17,18] . We also observed a decrease in the level of improvement of hydronephrosis and no or negligible increment of DRFs as the ages of children got higher.…”

Section: Discussionsupporting

confidence: 84%

A New Modification of Dismembered Pyeloplasty for Primary Ureteropelvic Junction Obstruction

Dayanç¹,

Kïbar²,

Irkılata³

et al. 2007

Eur Surg Res

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Aim: To present the results of a new modification of dismembered pyeloplasty performed to prevent the occurrence of secondary obstruction. Methods: Modified dismembered pyeloplasty was performed in 35 children (age range 3 months to 16 years) who had unilateral ureteropelvic junction obstruction. In postoperative follow-up, presence of hydronephrosis on ultrasonography, differential renal function (DRF) and renal drainage half-time on technetium-99m diethylenetriaminepentaacetic acid (DTPA) renography were recorded and compared with preoperative data. Results: Mean anteroposterior renal pelvic diameter, mean preoperative DRF and radioisotope clearance half-time on DTPA renography of the affected kidneys were 61.4 mm, 38.6% and 34.3 min in children with prenatal hydronephrosis, and 67.5 mm, 37.6% and 39.4 min in children that presented with symptoms, respectively. After surgery, mean anteroposterior renal pelvic diameter, mean DRF and radioisotope clearance half-time on DTPA renography of the affected kidneys were 10.9 mm, 45.9% and 11.9 min in children with prenatal hydronephrosis, and 20 mm, 41.9% and 15.2 min in children that presented with symptoms, respectively. No failure was observed in any patient at an average follow-up of 26 months (range 1–5 years). Conclusions: Open dismembered pyeloplasty is the treatment of choice for intrinsic ureteropelvic junction obstruction. The modification of dismembered pyeloplasty that we performed is an alternative for the prevention of secondary obstruction.

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Section: Discussionsupporting

confidence: 84%

A New Modification of Dismembered Pyeloplasty for Primary Ureteropelvic Junction Obstruction

Dayanç¹,

Kïbar²,

Irkılata³

et al. 2007

Eur Surg Res

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“…This opinion is supported by other authors. 14,16 In contrast, some reports have suggested there might be a limitation of functional recovery of antenatally detected hydronephrosis. Fig.…”

Section: Discussionmentioning

confidence: 97%

Delayed decrease in differential renal function after successful pyeloplasty in children with unilateral antenatally detected hydronephrosis

et al. 2007

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Aim:The aim of this study was to evaluate functional outcome of congenital hydronephrotic kidney. Methods: The records of consecutive children who underwent pyeloplasty for unilateral prenatally detected ureteropelvic junction obstruction were reviewed. Renal function was assessed renographically before and after surgery. Mean follow-up period was 100 months. Results: Sufficient pre-and postoperative data were available for 60 children. Differential renal function (DRF) improved in 14 (23%) and decreased in nine (15%) of 60 patients in the early postoperative period. DRF improved in seven (18%) and decreased in 13 (34%) of 38 patients at the end of follow-up. Five of 14 patients with increased DRF at early postoperative scan returned to the preoperative level at the end of follow-up. No patients with decreased DRF at early postoperative scan showed any recovery in DRF and progressive decrease was seen in four of nine children. Conclusions:The DRF was not stable in some patients after successful pyeloplasty. In some patients impairment of renal function came to be apparent with time. Improvement of DRF may be a transient phenomenon seen in the early postoperative period. To avoid overestimation of functional recovery, long-term follow-up with delayed renographic evaluation is recommended.

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“…With growing experience in laparoscopic techniques, there has gradually been a transition in paediatric surgery from ablative techniques to reconstructive procedures. Besides the established procedures like the laparoscopic nephrectomy and orchidopexy, procedures such as heminephrectomy and pyeloplasty have also proven to be applicable and feasible in both children and infants, respectively [4][5][6][7][8][9][10][11][12][13][14][15][16]. Penn et al found near equal results regarding outcomes in a comparative study laparoscopic pyeloplasty versus open approach [3].…”

Section: Introductionmentioning

confidence: 99%

Dismembered and non-dismembered retroperitoneoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction in children

et al. 2012

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Purpose Open dismembered pyeloplasty according to Anderson-Hynes (AHP) is the gold standard treatment for ureteropelvic junction obstruction in children. However, during the last decade, the management has been revolutionized with introduction of laparoscopy and endourology yielding comparable results and less morbid outcomes. Methods Between 1997 and 2010, dismembered and nondismembered retroperitoneoscopic pyeloplasty was performed in 41 children with a median age of 130 month (range 5-192). 20 children underwent a dismembered pyeloplasty (Anderson-Hynes) and 21 children were operated by a non-dismembered pyeloplasty (Y-V-Plasty). Results The mean operation time was 120 min (range 52-257). Intraoperative findings revealed in 29 cases a significant crossing vessel. Based on a furosemide nephrogram and subjective complaints, the success rate was 88 % with a median follow-up of 69 month (range 14-142). The 5 failures (2 Y-V-Plasty, 3 AHP) have been treated by open AHP (n = 2), Laser endopyelotomy (n = 2) and Lap-AHP (n = 1) without further problems. Conclusion With increasing improvement of the suture techniques, the laparoscopic pyeloplasty represents in experienced hands an alternative method with comparable success rates to the open technique. In our opinion, retroperitoneoscopic pyeloplasty is technically possible and feasible even in infants. We found in our series no statistically significant difference between dismembered and non-dismembered pyeloplasty.

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Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi‐ureteric junction obstruction?

Abstract: Objective To evaluate retrospectively children with an antenatal diagnosis of pelvi-ureteric junction (PUJ) obstruction who required pyeloplasty for deteriorating renal function during the follow-up, specifically assessing the recovery of function after surgery.

Cited by 87 publications

References 21 publications

A New Modification of Dismembered Pyeloplasty for Primary Ureteropelvic Junction Obstruction

A New Modification of Dismembered Pyeloplasty for Primary Ureteropelvic Junction Obstruction

Delayed decrease in differential renal function after successful pyeloplasty in children with unilateral antenatally detected hydronephrosis

Dismembered and non-dismembered retroperitoneoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction in children

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