Sonographic follow-up after pyeloplasty: a large, retrospective cohort analysis

Wickramasekara, Nipun; Ignatius, Jenosha; Lamahewage, Ananda

doi:10.1007/s00383-023-05422-0

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Ultrasound reveals kidney morphology, reflecting renal function improvements and predicting long-term outcomes, particularly through morphological recovery such as cortical restoration [7,8]. Previous research examined factors influencing UPJO prognosis, such as age, hydronephrosis degree, diagnosis time, and infections [4,9,10].…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Postoperative Outcomes in Children with Ureteropelvic Junction Obstruction: A Logistic Regression Analysis

Zhang,

Zhong,

Wang

et al. 2023

Preprint

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Background: Pediatric ureteropelvic junction obstruction (UPJO) is a common urinary tract issue. Accurate assessment of postoperative kidney function is crucial for prognosis. Previous studies mainly focused on postoperative renal function and individual factors. Radionuclide imaging was costly and unsuitable for long-term follow-up. For aligning closely with clinical needs, we emphasizing renal morphology enhancement, and comprehensively analyzed factors influencing UPJO surgery outcomes. Methods: We retrospectively studied 150 pediatric UPJO patients (July 2012-July 2022) with severe anteroposterior renal pelvis dilation (APD grades 4-5) who underwent laparoscopic dismembered pyeloplasty. Demographics, symptoms, preoperative findings, and postoperative renal ultrasounds were assessed. We performed multivariable logistic regression analysis to identify significant predictors of prognosis and construct a regression model. Results: Among the 150 pediatric patients, 78 (52%) showed improvement in renal morphology after surgery. In the multivariate logistic regression analysis, age at surgery, duration of hydronephrosis, body weight, and preoperative creatinine were identified as significant prognostic factors for postoperative outcomes. The nomogram (AUC: 0.92) was constructed based on these factors and could serve as a useful tool for clinicians in evaluating the surgical prognosis of children with UPJO. Conclusions: This study reveals that among pediatric patients with severe hydronephrosis resulting from UPJO, those who are younger, have a shorter duration of illness, normal serum creatinine levels, and a healthy body weight tend to experience better postoperative recovery. This finding emphasizes the importance of adopting more proactive clinical interventions when managing such cases, with the goal of achieving enhanced recovery outcomes for affected children.

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Section: Introductionmentioning

confidence: 99%

Factors Influencing Postoperative Outcomes in Children with Ureteropelvic Junction Obstruction: A Logistic Regression Analysis

Zhang,

Zhong,

Wang

et al. 2023

Preprint

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Diagnostic value of diuretic ultrasound in evaluating the need for reoperation in children undergoing pyeloplasty

Rashed,

Abbasioun,

Aghaee

et al. 2023

Afr J Urol

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Background Pyeloplasty currently stands as the standard treatment for UPJO. Our study aimed to assess the diagnostic value of sonographic parameters following Lasix administration in patients who underwent pyeloplasty to predict the recurrence of obstruction and the need for reoperation. Methods The study included 70 children with UPJO who underwent pyeloplasty. Renal ultrasound was performed on patients three to six months after pyeloplasty. Following the Lasix administration, the changes in ultrasound parameters at the 18th and 30th minute were documented. Within two weeks, patients underwent radioisotope renography. Diuretic ultrasound's diagnostic value in predicting the need for reoperation was assessed through a comparison with radioisotope renography. Results The average age of the patients was 3.94 ± 3.52 years. Anteroposterior diameter of the renal pelvis (APD) changes at 18 and 30 min, and the average APD after surgery at 18 and 30 min was significantly higher in patients requiring reoperation. The best cutoff point of APD changes in the 18th minute was 9.50 (sensitivity = 91.7%, specificity = 82.8%). The best cutoff point of APD after surgery in the 18th minute was 25.90 (sensitivity = 91.7%, specificity = 81.0%). The best cutoff points of the resistive index (RI) in the 18th and 30th minutes were reported as 0.70 (sensitivity = 41.7%, specificity = 50.0%) and 0.71 (sensitivity = 41.7%, specificity = 37.9%), respectively. Conclusions The assessment of ultrasound findings following pyeloplasty has revealed that changes in APD can serve as a reliable means for assessing the efficacy of the operation.

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Research Progress of Interstitial Cells of Cajal in Ureteropelvic Junction Obstruction

娜菲莎

2023

ACM

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Sonographic follow-up after pyeloplasty: a large, retrospective cohort analysis

Cited by 3 publications

References 14 publications

Factors Influencing Postoperative Outcomes in Children with Ureteropelvic Junction Obstruction: A Logistic Regression Analysis

Factors Influencing Postoperative Outcomes in Children with Ureteropelvic Junction Obstruction: A Logistic Regression Analysis

Diagnostic value of diuretic ultrasound in evaluating the need for reoperation in children undergoing pyeloplasty

Research Progress of Interstitial Cells of Cajal in Ureteropelvic Junction Obstruction

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