Resolution of hydronephrosis after pyeloplasty in children

Abstract

Background There is still a lack of knowledge regarding the natural course of resolution of hydronephrosis after pyeloplasty, and no consensus exists on how resolution of hydronephrosis is defined or when resolution is expected to occur. Objective To determine when resolution of hydronephrosis occurs following pyeloplasty, by type of obstruction and by surgical approach. Methods This retrospective study included 125 children age <15 years treated with pyeloplasty and followed for two years with repeated ultrasound and MAG3 scan. Children with single kidneys, bilateral disease, and without hydronephrosis were excluded. Children with reinterventions were excluded in the evaluation of hydronephrosis but not in terms of success rate. Outcomes time to resolution of hydronephrosis (Anterior-Posterior diameter (APD) <10 mm or >50% reduction of APD) and 2-year success rate. Exposure was surgical approach and type of obstruction (intrinsic/extrinsic). Survival analysis was performed, adjusting for age, gender, year, laterality, preoperative renal function on MAG3, calyces dilatation and APD in the multivariable analysis. Results At 12 months and 24 months follow-up, 90% and 93% had reached resolution, respectively. All children with persistent dilatation had improved drainage and stable

Introduction of Pediatric Robot-Assisted Pyeloplasty in A Low-Volume Centre

“…The follow-up is relatively short. Värelä and colleagues show, however, that follow-up beyond 12 months is not necessarily mandatory [ 20 ]. Despite these drawbacks, we believe that this pilot study still proves the viability of robotic surgery in our centre.…”

Sex differences in children operated with pyeloplasty for pelvoureteric junction obstruction

“…In the Kaplan–Meier curves, the primary outcome was resolution of hydronephrosis. Resolution was defined as APD < 10 mm [ 11 ] or a > 50% decrease in APD compared to preoperative values. When a patient had hydronephrosis preoperatively but no stated APD in the preoperative ultrasound report, a resolution was defined as APD < 10 mm postoperatively.…”

“…Around 20% of the patients with UPJO will eventually need a pyeloplasty [ 7 , 8 ]. Pyeloplasty improves long-term renal function [ 9 , 10 ] and about 90–100% of patients achieve resolution of their hydronephrosis after pyeloplasty [ 11 , 12 ].…”

Kết Quả Phẫu Thuật Tạo Hình Bể Thận – Niệu Quản Theo Chỉ Số Pi – Apd Điều Trị Thận Ứ Nước Bẩm Sinh Ở Trẻ Em

“…Tỷ lệ cải thiện đường kính trước sau bể thận sau mổ (percent improvement in renal pelvis anterior -posterior diameter, PI-APD) ≥ 38% được định nghĩa là thành công, PI-APD là tỷ lệ % cải thiện đường kính trước -sau bể thận = (đường kính trước sau bể thận trước mổ trừ đường kính trước -sau bể thận sau mổ) / đường kính trước -sau bể thận trước mổ x 100 ≥ 38% được định nghĩa là kết quả phẫu thuật thành công, ngược lại được gọi là thất bại [6]. Bên cạnh đó, thời gian cải thiện sau mổ tình trạng giãn bể thận -niệu quản chậm, tỷ lệ cải thiện cao với thời gian theo dõi ít nhất là 24 tháng sau mổ [7]. Trên cơ sở đó, đề tài nghiên cứu kết quả tạo hình bể thận niệu quản điều trị thận ứ nước bẩm sinh dựa vào chỉ số PI -APD với thời gian theo dõi ít nhất 24 tháng.…”