Can Renal Ultrasonography Predict Early Success after Pyeloplasty in Children? A Prospective Study

Helmy, Tamer E.; Harraz, Ahmed M.; Sharaf, Doaa Elsayed; Demerdash, Yasser El; Hafez, Ashraf T.; Gad, Hossam M.; Dawaba, Mohamed

doi:10.1159/000362504

Cited by 16 publications

(11 citation statements)

References 19 publications

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“…Since LP started to get popularized within the last 2 decades, the surgical steps of the procedure have been the subject of numerous publications [6,7,8,9,10]. Of the surgical steps that affects the operative time and success, stenting is another critical step of the procedure.…”

Section: Discussionmentioning

confidence: 99%

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

Kalkan

Ersöz²,

Armağan³

et al. 2016

Urol Int

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Objective: There are 2 critical steps of stent placement during laparoscopic pyeloplasty (LP) in children. Introduction to the ureteropelvic junction and passing through the ureterovesical junction. We aimed at overcoming those 2 steps by creating a modified technique. Methods: Consecutive 27 children undergoing transperitoneal laparoscopic dismembered pyeloplasty by a single surgeon were prospectively enrolled into this study. The modifications of our technique are using an Amplatz dilator and a closed tip stent. Results: The mean age of the children was 6.7 (range 4 months-17 years). The mean time of stent insertion was 2.7 ± 2.0 (2-6) min and the operative time was 128.3 ± 17.6 (90-180) min. The mean number of days of hospital stay was 2.0 ± 0.4 (1-3). After a mean follow-up period of 20.3 ± 4.2 (14-30) months, no operative failure was detected. Conclusion: Our modified technique is a completion of the current armamentarium for stent placement during LP in infants and children.

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Section: Discussionmentioning

confidence: 99%

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

Kalkan

Ersöz²,

Armağan³

et al. 2016

Urol Int

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“…During the intervention, the operator reduces the effective dose to the minimum, and it is promoted the use of radiation shields where possible. Following the recommendations of recent data ( 27 – 30 ), we have changed the postoperative image follow-up protocol and the postoperative MAG-III diuretic renogram is only performed on those patients with postoperative ultrasound worsening. Following this protocol, in up to 61 patients the MAG-3 diuretic renogram could have been avoided.…”

Section: Discussionmentioning

confidence: 99%

Long Term Outcome of 112 Pediatric Patients With Ureteroplevic Junction Obstruction Treated by Endourologic Retrograde Balloon Dilatation

et al. 2022

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PurposeTo analyze the effectiveness, complications and long-term outcome of the patients with ureteropelvic junction obstruction (UPJO) treated by endoscopic retrograde balloon dilatation (ERBD) in the largest series reported.Materials and MethodsBetween years 2004 and 2018, 112 patients with primary unilateral UPJO were treated by ERBD. Endoscopic treatment consisted on a retrograde balloon dilatation of the ureteropelvic junction (UPJ), through cystoscopy and under fluoroscopic guidance, using high-pressure balloon catheters. In case of persistence in the balloon notch, a Cutting Balloon™ catheter was used. Double-J stent was placed after dilatation.ResultsMean age at surgery was 13.1 ± 21.3 months, 92 cases being younger than 18 months. Mean operative time was 24.4 ± 10.3 min; hospital stay was 1 day in 82% of patients. No intraoperative complications occurred. UPJ was calibrated at time of stent removal with cystoscopy 39.1 ± 13.7 days after dilatation. ERBD was not possible in 11 cases. An additional procedure was needed in 24 cases: second ERBD (n = 11, seven during the stent withdrawal), a third dilatation (n = 3) due to persistent hydronephrosis, and percutaneous endopyelotomy (n = 3) or open pyeloplasty (n = 7) in cases of technical failure. Significant improvement in postoperative ultrasound measures were observed (p < 0.05, T-test). Long-term success rate was 76.8% after one dilatation, and 86.6% in those who required up to 2 dilatations. Mean follow-up was 66.7 ± 37.5 months.ConclusionsERBD is a feasible and safe option for the minimally invasive treatment of UPJ obstruction in infants. Long-term outcome is acceptable with a very low complication rate.

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“…Renal morphological indices, such as APD of pelvic and PT, are the most used measures to assess the severity of hydronephrosis and predict the improvement of renal function after pyeloplasty ( 22 , 23 ). In our study, APD of pelvic and PT of infants in both groups recovered to varying degrees after surgery and during follow-up, but the IT group was more significant.…”

Section: Discussionmentioning

confidence: 99%

Outcome analysis of immediate and delayed laparoscopic pyeloplasty in infants with severe ureteropelvic junction obstruction

Bao

Ma²,

Zhang³

et al. 2022

Front. Pediatr.

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ObjectiveThe treatment timing of ureteropelvic junction obstruction (UPJO) in infants remains controversial. This study aimed to compare the recovery effect of renal morphology of immediate and delayed laparoscopic pyeloplasty in infants with severe UPJO.MethodsThe infants with severe UPJO-induced hydronephrosis who underwent laparoscopic pyeloplasty according to their age at the time of surgery [the immediate treatment (IT) group: ≤1 month of birth, the delayed treatment (LT) group: 3–6 months of birth] in our center between 2010 and 2019 were enrolled in this study. Ultrasonography was used to assess renal morphology, including anteroposterior diameter (APD) of a pelvic, parenchymal thickness (PT), polar length (PL), and Society of Fetal Urology (SFU) grade. Preoperative and postoperative renal morphological outcomes at 6, 12, and 24 months were measured and compared.ResultsDuring this period, a total of 135 patients were assigned to receive either IT (n = 73) or LT (n = 62) and were included for analysis. There were no significant differences in renal morphology indices at baseline between groups of IT and LT. The APD, PT, and PL in both groups all recovered to certain degrees compared with those at baseline, however, the IT group recovered more significantly than the LT group. Despite there being no significant difference in SFU grade between the two groups before and after surgery, the reduction of SFU grade in the IT group was more significant than that in the LT group during the 6-, 12- and 24-month follow-up periods. The PL, SFU, and APD were greater in the IT group than in the LT group at 6, 12, and 24 months of follow-up. At 6 months PL was not significantly higher between the two groups, while the outcome was significantly different at 12 months and 24 months.ConclusionImmediate laparoscopic pyeloplasty for the infant with severe ureteropelvic junction obstruction is effective, and it can accelerate the recovery of renal morphological indices in infants with severe UPJO-induced hydronephrosis.

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Can Renal Ultrasonography Predict Early Success after Pyeloplasty in Children? A Prospective Study

Cited by 16 publications

References 19 publications

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

A Modified Antegrade Stenting Technique for Laparoscopic Pyeloplasty in Infants and Children

Long Term Outcome of 112 Pediatric Patients With Ureteroplevic Junction Obstruction Treated by Endourologic Retrograde Balloon Dilatation

Outcome analysis of immediate and delayed laparoscopic pyeloplasty in infants with severe ureteropelvic junction obstruction

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