Functional and Morphological Outcomes of Pyeloplasty at Different Ages in Prenatally Diagnosed Society of Fetal Urology Grades 3-4 Ureteropelvic Junction Obstruction: Is It Safe to Wait?

Jiang, Dapeng; Tang, Bingqiang; Xu, Min; Lin, Houwei; Jin, Lin‐Yu; He, Lei; Xu, Guofeng; Fang, Xiaoliang; Geng, Hui

doi:10.1016/j.urology.2016.10.004

Cited by 19 publications

(10 citation statements)

References 21 publications

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“…Jiang et al suggest performing an early pyeloplasty in patients with prenatally diagnosed SFU grades 3-4 UPJO because prolonged waiting might affect renal functional recovery [14]. Tabari et al, in the same way, showed how an early intervention induces an improvement in anatomic and functional values, while a delayed correction of UPJO implicates a major risk of renal function deterioration [15].…”

Section: Discussionmentioning

confidence: 99%

Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

Lima¹,

Salvo²,

Portoraro³

et al. 2021

Children

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There is no univocal consensus about timing of intervention and best surgical approach for infants with asymptomatic uretero-pelvic junction obstruction (UPJO). We conducted a retrospective analysis of patients undergoing one-trocar-assisted pyeloplasty (OTAP) in a 13 year range period by creating two homogenous groups (indications for surgery were the same for all patients): patients operated on in the first 90 days of life (34 patients; Group 1) and patients operated on between 3 and 12 months of life (34 patients; Group 2). We observed no statistically significant differences between groups in regard to mean operative time, conversion rate to open surgery, mean hospital stay, early complications (urinary leakage) rate and mean antero-posterior diameter (APD) reduction rate. Moreover, no statistical improvement was seen between groups in regard to separate renal function (SRF) at 1-year-follow-up renogram. Thanks to the HSS calculated before and 1 year after surgery, we registered an important improvement in Group I patients (p = 0.023). In our study, there was no significant evidence, in terms of intraoperative data and early postoperative outcomes, between patients who underwent an early pyeloplasty and those who underwent a delayed correction. Nevertheless, we registered a significant improvement in those patients with an impaired SRF that underwent an early surgical correction, especially in terms of urinary flow. Even though this study cannot definitely establish the superiority of early timing of correction, it is evident that further research is needed to clarify this aspect.

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Section: Discussionmentioning

confidence: 99%

Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

Lima¹,

Salvo²,

Portoraro³

et al. 2021

Children

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“…Some surgical procedures that can be delayed without an immediate risk to the life or health of the patient may still have adverse consequences from waiting, as in the case of pyeloplasty and adolescent herniorrhaphy. [5][6][7] Lengthy delays already exist for families trying to gain access to pediatric subspecialty appointments, such as for children with cleft palate. 8 Such delays increase anxiety and stress for families and could result in a worsening of the patient's clinical condition.…”

Section: Medical Needsmentioning

confidence: 99%

Seeking Normalcy as the Curve Flattens: Ethical Considerations for Pediatricians Managing Collateral Damage of Coronavirus Disease-2019

Feltman

Moore

Beck

et al. 2020

The Journal of Pediatrics

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F earful. Uncertain. Overwhelmed. Committed. Hopeful. Pediatricians around the world have cycled through these emotions when considering the health and safety of patients and families during this coronavirus disease 2019 (COVID-19) pandemic. We worry about the direct medical effects of COVID-19. We also worry about the ancillary effects of the lockdowns, stay-at-home orders, closed clinics, schools, and daycare centers, and newly unemployed parents on the well-being of children. We focus on those concerns. We believe that responding to these ancillary effects of COVID-19 will be a bigger challenge for pediatricians than the clinical care of children with COVID-19. These challenges will be with us for the foreseeable future.

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“…Congenital ureteropelvic junction obstruction (UPJO) is one of the most commonly encountered abnormalities that are responsible for persistent hydronephrosis in children ( 1 ). The classic option of treatment for UPJO is pyeloplasty.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Drainage Methods After Pyeloplasty in Children: A 14-Year Study

Kong

et al. 2021

Front. Pediatr.

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Objective: To summarize our experiences with drainage methods after laparoscopic pyeloplasty with a 14-year study.Methods: We reviewed the data of the 838 children operated on for hydronephrosis due to congenital ureteropelvic junction obstruction (UPJO) between July 2007 and July 2020. Patients' demographics, perioperative details, postoperative drainage stents [including double-J stent, percutaneous trans-anastomotic (PU) stent, and trans-uretero-cystic external urethral stent (TEUS)], complications, hospital stay, and long-term follow-up outcomes were analyzed. Long-term follow-up was performed by outpatient visits and telephone follow-up. Moreover, we reviewed the details of nine cases of recurrence after laparoscopic pyeloplasty.Results: Comparison of preoperative general data among the three groups indicated that there was no statistical difference in age, gender, and surgical side of the three groups. Statistical differences were found in the incidence of postoperative complications from the three postoperative drainage method groups, especially the incidence of reoperations (p < 0.01): there were six cases (3.19%) of recurrences in the TEUS group, two cases (0.36%) in the DJ group, and one case (0.93%) in the PU group. In the six recurrent cases from the TEUS group, four cases (44.4%) were found to have stenosis, and two cases (22.2%) have iatrogenic valvular formation.Conclusion: Not all three types of drainage methods are suitable for drainage after pyeloplasty. Based on our findings, TEUS is not recommended.

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Functional and Morphological Outcomes of Pyeloplasty at Different Ages in Prenatally Diagnosed Society of Fetal Urology Grades 3-4 Ureteropelvic Junction Obstruction: Is It Safe to Wait?

Cited by 19 publications

References 21 publications

Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

Seeking Normalcy as the Curve Flattens: Ethical Considerations for Pediatricians Managing Collateral Damage of Coronavirus Disease-2019

Comparison of Drainage Methods After Pyeloplasty in Children: A 14-Year Study

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