Postoperative Diuresis Renography and Ultrasound in Patients Undergoing Pyeloplasty Predictors of Surgical Outcome

Neste, Michael G.; Cret, R; Finlay, D E; Sane, Shashikant M.; Gonzalez, R. Sigüenza; Boudreau, Robert J.; Kuni, Christopher C.

doi:10.1097/00003072-199310000-00010

Cited by 47 publications

(29 citation statements)

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“…For endopyelotomy and pyeloplasty we contend that patients should have long-term followup, which is contradictory to what has been recommended in the past. 14,15 In addition, we have changed our followup for endopyelotomy and pyeloplasty to be more consistent with our findings. Although we still see patients every 3 to 6 months in the year after treatment with a functional study, we now see them annually thereafter with renal ultrasound and diuretic renogram, if needed, to evaluate for new hydronephrosis, cortical loss or return of symptoms.…”

Section: Discussionsupporting

confidence: 74%

The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction: A Review of Our Experience During the Last Decade

et al. 2008

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Section: Discussionsupporting

confidence: 74%

The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction: A Review of Our Experience During the Last Decade

et al. 2008

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“…Amling et al [4] reviewed the degree of pyelocaliectasis after pyeloplasty in 44 patients with PUJ obstruction, showing that pyelocaliectasis grade was the same or worse 1 month after pyeloplasty in 33 of the 36 kidneys at this interval (two worse and 31 unchanged). Neste et al [1] used renal US to evaluate disease grade and renal pelvic diameter after pyeloplasty, noting that less than half the US studies improved by grade in the ®rst 6 months of the follow-up, whereas the C/P ratio might have re¯ected the renogram improvement, and clinically favourable outcome.…”

Section: Discussionmentioning

confidence: 99%

Calyx to parenchyma ratio in pelvi-ureteric junction obstruction

Imaji¹,

Dewan²

2002

BJU Int

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Objective To review the ultrasonography of patients who had undergone pyeloplasty for pelvi-ureteric junction (PUJ) obstruction, and document the changes in calyceal distension and parenchymal thickness after pyeloplasty, to attempt to establish an additional prognostic indicator. Patients and methods Fifty-eight patients who underwent pyeloplasty for PUJ obstruction were assessed retrospectively. Pre-and postoperative ultrasonograms were analysed for both pyelocaliectasis, graded according to the Society for Fetal Urology criteria, and the ratio of the depth of calyces to the thickness of the parenchyma (C/P ratio). Patients underwent nuclear medicine renography before and 3 months after pyeloplasty. The results were analysed using the paired t-test, Kruskal±Wallis test, Spearman's correlation coef®cient by rank test and the MannWhitney U-test. Results There was no signi®cant difference in hydronephrosis grade before and after surgery (P<0.05) but there was a signi®cant difference in the C/P ratios (P<0.01). There was no correlation between C/P ratios and the results of diuresis renography. Conclusion Hydronephrosis as measured by an estimate of pelvic volume is an insensitive marker of improvement after pyeloplasty. Reduced calyceal distension correlates well with other favourable prognostic indicators. Therefore, the C/P ratio may be an additional indicator of the appropriateness of surgical intervention, and should be the subject of further study.

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“…Halen klinik yaklaşımımızı yönlendiren birkaç çalışma dışında pyeloplasti sonrası cerrahi başarının yeterli prediktörleri yeterince araştırılmamıştır (15,16). Biz, erken postoperatif dönemdeki gecikmelerden kaçınmak için erken postoperatif kriterlerin belirlenmesi gerektiğini düşünmekteyiz.…”

Section: Bulgularunclassified

“…Ancak bu süreyi öngörmek mümkün değildir. Neste ve arkadaşları (16), pediatrik popülasyonda pyeloplasti sonrası pelvik çap ve hidronefroz derecesinde dereceli bir gelişim olduğunu bildirmiştir. Amling ve arkadaşları (17), US verilerine dayanarak, postoperatif ilk 6 ayda böbreklerin %38'inde gelişim olduğu-nu bildirmektedir.…”

Section: Bulgularunclassified

Pelvic Reduction During Pyeloplasty for Antenatal Hydronephrosis: Does It Affect Outcome in Ultrasound and Nuclear Scan Postoperatively?

Burgu¹,

Süer²,

Öztürk³

et al. 2012

JAREM

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ÖZETAmaç: Burada randomize prospektif kontrollü bir çalışma yapılarak pyeloplastide pelvik redüksiyon yapılan ve yapılmayan olguların operasyon sonrası ultrasonografi (USG) ve sintigrafi sonuçları karşılaştırılmıştır.Yöntemler: Çalışmaya prenatal tanı konulmuş 42 unilateral hidronefrozlu hasta dahil edildi. Hidronefrozun postnatal olarak devam ettiği gösterildi. Randomize olarak 20 hastaya pyeloplasti+pelvik redüksiyon ve diğer 22 hastaya da pelvis kloruyucu pyeloplasti yapıldı. Hastalar postoperatif 1, 3 ve 6. ayda USG; 6. ayda merkaptoasetiltriglisin-3 (MAG-3) sintigrafi taramasıyla ile değerlendirildi. Ortalama takip süresi 37±5.6 hafta idi. İstatistiksel analiz ki kare testi kullanılarak yapıldı ve p değeri <0.05 kabul edildi. Güç analizi için NCSS-PAS programı kullanıldı. 0.84'ün güç değeri 42 hasta için hesaplandı.Bulgular: Erken postoperatif dönemde pelvik redüksiyon yapılan grupta USG taramasında anteroposterior çapın rezolüsyonu daha belirgin olmaktadır. Pelvik redüksüyon yapılan grupta t ½ azalması daha belirgin olsa da, bu değerin klinik uygulamadaki faydaları halen tartışmalıdır. Bu özellik yine de olası cerrahi hataların erken tanınmasını sağlayabilir ve postoperatif USG ve renografinin değerini artırabilme potansiyeline sahiptir.Sonuç: Anteroposterior pelvis çapının postoperatif 1. ve 3. ay USG ölçümlerinde pelvik redüksiyon yapılan grupta pelvis koruyucu cerrahi yapılan gruba oranla daha büyük oranda azaldığı ancak 6. ay yapılan ölçümlerde arada anlamlı fark olmadığı anlaşıldı. Postoperatif 6. ayda yapılan MAG-3 renografide renal boşalma zamanının (t ½) pelvik redüksiyonlu grupta anlamlı olarak kısaldığı anlaşıldı. Separe böbrek fonksiyonlarının ise redüksiyondan etkilenmediği bulundu. (JAREM 2012; 2: 71-6) Anahtar Sözcükler: Antenatal hidronefroz, pelvik redüksiyon, piyeloplasti, üreteropelvik bileşke obstrüksiyonu, USG, sintigrafi ABSTRACT Objective: To compare ultrasound (US) scan and nuclear renography findings in patients who underwent pyeloplasty with and without pelvic reduction in a randomized prospective study.Methods: A total of 42 patients, all prenatally diagnosed with unilateral hydronephrosis, were included. Hydronephrosis was confirmed postnatally. Twenty patients were randomly selected to undergo pyeloplasty with pelvic reduction and 22 underwent pelvis-sparing pyeloplasty. Patients were evaluated with mercaptoacetyltriglycine-3 scans on the sixth month and US scans on the first, third, and sixth months, postoperatively. Mean follow-up was 37± 5.6 weeks. Statistical analyses were performed using chi-square test and significance was set as p<.05. Power analyses were performed by the NCSS-PASS program. A power value of 0.84 was calculated for a sample size of 42.Results: The anteroposterior pelvic diameter decreased significantly in the pelvic reduction group compared with the pelvis-sparing group in the firstand third-month US scans. However, the difference was not significant in the sixth month. The improvements in the US findings for the pelvis-sparing group match with those of...

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Postoperative Diuresis Renography and Ultrasound in Patients Undergoing Pyeloplasty Predictors of Surgical Outcome

Cited by 47 publications

References 0 publications

The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction: A Review of Our Experience During the Last Decade

The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction: A Review of Our Experience During the Last Decade

Calyx to parenchyma ratio in pelvi-ureteric junction obstruction

Pelvic Reduction During Pyeloplasty for Antenatal Hydronephrosis: Does It Affect Outcome in Ultrasound and Nuclear Scan Postoperatively?

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