Pediatric Pyeloplasty in the Poor Function Kidneys: Does Surgical Success Guarantee Improvement in Renal Function? Single-Center Experience and Review of Literature
Urology Journal,
Vol. 21 No. 01 (2024),
28 February 2024
,
Page 52-56
https://doi.org/10.22037/uj.v20i.7768
Abstract
Purpose: To investigate the effect of pyeloplasty in pediatric patients with poor function kidneys, focusing on the split renal function (SRF) and anteroposterior diameter (APD) of the renal pelvis.
Materials and Methods: A retrospective study included 47 pediatric patients with ureteropelvic junction obstruction (UPJO) who underwent open pyeloplasty with SRF< 20%. All patients were recruited from the Labbafinejad University Hospital center from April 2014 to October 2020. The results of preoperative ultrasonography and Diethylenetriamine pentaacetate (DTPA) scan compared with the results of the ultrasonography and DTPA scan 6 months and one year after surgery. Finally, Wilcoxon signed-rank test was used to test differences the SPSS (version 25) software statistical computer package.
Results: The mean age of participants was 1.5 years. There were 34 cases with SRF between 10% and 20%, and 13 cases with SRF < 10%. The findings showed that pyeloplasty for UPJO leads to a significant improvement in renal function in poorly functioning renal units with 10% ≤ SRF < 20%. Although improvement in renal function occurred in the group with SRF of less than 10%, it was not statistically significant. The APD in both groups was statistically significantly improved. No correlation between genders and outcomes was found.
Conclusion: Poorly functioning renal unit (SRF < 20%) can show functional improvement after the pyeloplasty.
- Ureteropelvic junction obstruction
- split renal function
- pyeloplasty
- pediatrics
- anteroposterior diameter
How to Cite
References
Ibrahim Selmy G, Mohamed Salih E-S, Salah El-Din Zykri M, Abd El-Maksoud AE-K. outcome of pediatric pyeloplasty in renal units with split renal function less than 20%. Al-Azhar Medical Journal. 2019;48:489-500.
Abdelaziz A, Shaker H, Aly H, Aldaqados H, Hussein E. Early outcome of pediatric pyeloplasty in kidneys with split renal function less than 10%: A prospective study of 25 cases. African Journal of Urology. 2018;24:324-30.
Wagner M, Mayr J, Häcker F-M. Improvement of renal split function in hydronephrosis with less than 10% function. European journal of pediatric surgery. 2008;18:156-9.
Helmy TE, Harraz A, Sharaf DE, et al. Can renal ultrasonography predict early success after pyeloplasty in children? A prospective study. Urol Int. 2014;93:406-10.
Thorup J, Jokela R, Cortes D, Nielsen O. The results of 15 years of consistent strategy in treating antenatally suspected pelvi‐ureteric junction obstruction. BJU international. 2003;91:850-2.
Dhillon H. Prenatally diagnosed hydronephrosis: the Great Ormond Street experience. Br J Urol. 1998;81:39-44.
Lone YA, Samujh R, Bhattacharya A, Kanojia RP. Outcome of poorly functioning kidneys secondary to PUJO preserved by pyeloplast. Journal of Pediatric Surgery. 2017;52:578-81.
Menon P, Rao KLN, Bhattacharya A, Mittal BR. Outcome analysis of pediatric pyeloplasty in units with less than 20% differential renal function. Journal of Pediatric Urology. 2016;12:171. e1-. e7.
Aziz M, Hossain A, Banu T, et al. In hydronephrosis less than 10% kidney function is not an indication for nephrectomy in children. European journal of pediatric surgery. 2002;12:304-7.
Pascual L, Oliva J, Vega PJ, Príncipi I, Vallés P. Renal histology in ureteropelvic junction obstruction: are histological changes a consequence of hyperfiltration? J Urol. 1998;160:976-9; discussion 94.
Fernbach S, Maizels M, Conway J. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatric radiology. 1993;23:478-80.
Has R, Sarac Sivrikoz T. Prenatal diagnosis and findings in ureteropelvic junction type hydronephrosis. Frontiers in pediatrics. 2020;8:492.
Radulović M, Beatović S, Janković M, Šobić-Šaranović D, Artiko V, Ajdinović B. Diuresis renography and ultrasonography in children with antenatally detected hydronephrosis can support diagnoses and suggest related surgery treatment. Hell J Nucl Med. 2017;20 Suppl:25-36.
ul Haq A, Khan I. Tubeless and stentless pyeloplasty. Journal of Postgraduate Medical Institute. 2003;17.
Bansal R, Ansari M, Srivastava A, Kapoor R. Long-term results of pyeloplasty in poorly functioning kidneys in the pediatric age group. Journal of Pediatric Urology. 2012;8:25-8.
Tolstrup RS, Pank MT, Sander L, Dørflinger T. Laparoscopic pyeloplasty for ureteropelvic junctions obstruction in adults: 6 years’ experience in one center. BioMed Research International. 2017;2017.
Ji F, Chen L, Wu C, Li J, Hang Y, Yan B. Meta-Analysis of the Efficacy of Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction via Retroperitoneal and Transperitoneal Approaches. Front Pediatr. 2021;9:707266.
González ST, Rosito TE, Tur AB, et al. Multicenter comparative study of open, laparoscopic, and robotic pyeloplasty in the pediatric population for the treatment of ureteropelvic junction obstruction (UPJO). Int Braz J Urol. 2022;48:961-8.
Salem YH, Majd M, Rushton HG, Belman AB. Outcome analysis of pediatric pyeloplasty as a function of patient age, presentation and differential renal function. The Journal of urology. 1995;154:1889-93.
Gupta D, Chandrasekharam V, Srinivas M, Bajpai M. Percutaneous nephrostomy in children with ureteropelvic junction obstruction and poor renal function. Urology. 2001;57:547-50.
Cornford, Rickwood. Functional results of pyeloplasty in patients with ante‐natally diagnosed pelvi‐ureteric junction obstruction. British journal of urology. 1998;81:152-5.
Kis E, Verebély T, Kövi R, Máttyus I. The role of ultrasound in the follow-up of postoperative changes after pyeloplasty. Pediatric radiology. 1998;28:247-9.
Stock JA, Krous HF, Heffernan J, Packer M, Kaplan GW. Correlation of renal biopsy and radionuclide renal scan differential function in patients with unilateral ureteropelvic junction obstruction. The Journal of urology. 1995;154:716-8.
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