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Pelvic reduction during pyeloplasty for antenatal hydronephrosis: does it affect outcome in ultrasound and nuclear scan postoperatively?

Artikel i vetenskaplig tidskrift
Författare Berk Burgu
Evren Suer
Özgu Aydogdu
Tarkan Soygur
Publicerad i Urology
Volym 76
Nummer/häfte 1
Sidor 169-74
ISSN 1527-9995
Publiceringsår 2010
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för farmakologi
Sidor 169-74
Språk en
Länkar dx.doi.org/10.1016/j.urology.2009.0...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adolescent, Child, Female, Humans, Hydronephrosis, diagnostic imaging, pathology, surgery, Kidney Pelvis, surgery, Male, Postoperative Care, Prospective Studies, Radioisotope Renography, Treatment Outcome, Ultrasonography, Urologic Surgical Procedures, methods
Ämneskategorier Pediatrik, Njursjukdomar, Urologi och andrologi, Urologi och njurmedicin, Radiologi, Diagnostisk radiologi, Klinisk medicin

Sammanfattning

To compare ultrasound (US) scan and nuclear renography findings in patients who underwent pyeloplasty with and without pelvic reduction in a randomized prospective study.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.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(1/2)) 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.Resolution of anteroposterior diameter in US scan is more prominent in the pelvic reduction group at earlier stages of the postoperative period. Although T(1/2) 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.

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