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

被引:14
作者
Burgu, Berk [1 ]
Suer, Evren [1 ]
Aydogdu, Ozgu [1 ]
Soygur, Tarkan [1 ]
机构
[1] Ankara Univ, Dept Urol, Div Pediat Urol, Sch Med, TR-06100 Ankara, Turkey
关键词
RENAL PELVIS; ELECTROSURGICAL ENDOPYELOTOMY; UNILATERAL HYDRONEPHROSIS; DIURETIC RENOGRAPHY; PORCINE MODEL; MANAGEMENT; DIURESIS; OBSTRUCTION; CHILDREN;
D O I
10.1016/j.urology.2009.09.080
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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. 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 pelvis-sparing group in the first-and 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 the pelvic reduction group later in the postoperative period. Pelvic reduction significantly improved the renal washout time (T) in mercaptoacetyltriglycine-3 renography when compared with pyeloplasty group without reduction at postoperative sixth month. Differential renal function was found to be unaffected from pelvic reduction. CONCLUSIONS Resolution of anteroposterior diameter in US scan is more prominent in the pelvic reduction group at earlier stages of the postoperative period. Although T decreases more prominently in the pelvic reduction group, the utility of this procedure is still indecisive. This feature can reveal possible surgical failures earlier and strengthen the values of US and renography postoperatively. UROLOGY 76: 169-174, 2010. (C) 2010 Elsevier Inc.
引用
收藏
页码:169 / 174
页数:6
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