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Does a Preoperative Percutaneous Nephrostomy Influence the Outcome of Pyeloplasty in Infants and Children?

Does a Preoperative Percutaneous Nephrostomy Influence the Outcome of Pyeloplasty in Infants and... Introduction: We evaluated the potential and outcome of preoperative percutaneous nephrostomy (PCN) in infants and children with severe hydronephrosis (Society for Fetal Urology grade IV) due to ureteropelvic junction obstruction. We focused on pre- and post-operative renal split function (RSF), histological findings of the renal pelvis and the reop-eration rate. Patients and Methods: The medical records of 249 patients (254 renal units) who underwent pyeloplasty for ureteropelvic junction obstruction between 1992 and 2009 were retrospectively reviewed. In 24 patients (group 1), PCN was performed before the pyeloplasty for various reasons. Renal split function was investigated using diuretic renogra-phy before PCN or pyeloplasty and 1 year after surgery. His-tological findings and reoperation rates were compared in patients with (group 1) and without (group 2) PCN. Results: Of the 254 renal units, 24 patients with a median age of 80 days (1 day to 11 years) received a PCN before pyeloplasty. The initial median RSF was 43% (4–58%) preoperatively and 45% (21–67%) 1 year postoperatively in group 1 and 47% (11–71%) preoperatively and 47% (0–74%) postoperatively in group 2. Histology revealed chronic inflammation of the renal pelvis in 60% of the PCN patients compared to 21% in group 2. The reoperation rate was 12.5% (3/24) in group 1 and 4% (9/230) in group 2. Conclusions: Preoperative PCN in severe hydronephrosis results in little or no improvement in RSF, causes a high percentage of chronic inflammation of the renal pelvis and increases the risk of reoperation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Urology Karger

Does a Preoperative Percutaneous Nephrostomy Influence the Outcome of Pyeloplasty in Infants and Children?

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References (19)

Publisher
Karger
Copyright
© 2009 S. Karger AG, Basel
ISSN
1661-7649
eISSN
1661-7657
DOI
10.1159/000253379
Publisher site
See Article on Publisher Site

Abstract

Introduction: We evaluated the potential and outcome of preoperative percutaneous nephrostomy (PCN) in infants and children with severe hydronephrosis (Society for Fetal Urology grade IV) due to ureteropelvic junction obstruction. We focused on pre- and post-operative renal split function (RSF), histological findings of the renal pelvis and the reop-eration rate. Patients and Methods: The medical records of 249 patients (254 renal units) who underwent pyeloplasty for ureteropelvic junction obstruction between 1992 and 2009 were retrospectively reviewed. In 24 patients (group 1), PCN was performed before the pyeloplasty for various reasons. Renal split function was investigated using diuretic renogra-phy before PCN or pyeloplasty and 1 year after surgery. His-tological findings and reoperation rates were compared in patients with (group 1) and without (group 2) PCN. Results: Of the 254 renal units, 24 patients with a median age of 80 days (1 day to 11 years) received a PCN before pyeloplasty. The initial median RSF was 43% (4–58%) preoperatively and 45% (21–67%) 1 year postoperatively in group 1 and 47% (11–71%) preoperatively and 47% (0–74%) postoperatively in group 2. Histology revealed chronic inflammation of the renal pelvis in 60% of the PCN patients compared to 21% in group 2. The reoperation rate was 12.5% (3/24) in group 1 and 4% (9/230) in group 2. Conclusions: Preoperative PCN in severe hydronephrosis results in little or no improvement in RSF, causes a high percentage of chronic inflammation of the renal pelvis and increases the risk of reoperation.

Journal

Current UrologyKarger

Published: Jan 1, 2009

Keywords: Percutaneous nephrostomy; Pyeloplasty; Chronic inflammation

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