Predictive Factors of Contralateral Operation after Initial Pyeloplasty in Children with Antenatally Detected Bilateral Hydronephrosis Due to Ureteropelvic Junction Obstruction
Predictive Factors of Contralateral Operation after Initial Pyeloplasty in Children with Antenatally Detected Bilateral Hydronephrosis Due to Ureteropelvic Junction Obstruction
复制标题
产前发现肾盂输尿管连接部梗阻双侧肾积水患儿首次肾盂成形术后对侧手术的预测因素
DOI：
10.1159/000487196
复制
发表时间：
2018
影响因子：
1.6
通讯作者：
Hongquan Geng
中科院分区：
文献类型：
--
作者：
Dapeng Jiang;Zhoutong Chen;Houwei Lin;Mao;Hongquan Geng
目的：本研究旨在分析产前发现双侧肾盂输尿管连接部梗阻的患者在初次肾盂成形术后进行对侧手术的预测因素。研究方法：接受初次肾盂成形术的产前诊断为双侧肾盂输尿管连接部梗阻的患者（初次肾盂成形术时年龄<12个月）参与本研究。患者招募时间为2012年1月至2015年12月。评价肾盂前后径、肾实质厚度和肾盏扩张情况。对单侧肾盂成形术后对侧肾盂成形术的预测因素也进行了研究。结果：共有82例患者纳入研究（平均年龄2.8个月）。在接受初始肾盂成形术的所有患者中，11例患者（13.4%）需要额外的对侧肾盂成形术。对侧肾积水的结局评估为消退、持续或手术。各组间肾盂前后径及肾盏扩张的中位值有显著性差异（P < 0.001）。肾盏扩张≥10 mm和肾盏扩张/实质厚度比值≥5强烈提示对侧手术的可能性。结论：在大多数双侧肾盂输尿管连接部梗阻的患者中，最初的单侧肾盂成形术可以改善或解决对侧肾积水。对侧肾盏扩张>10 mm且肾盏扩张/实质厚度比>5的患者手术风险较高。
Objectives: This study was performed to analyze the predictive factors of a contralateral operation after initial pyeloplasty in patients with antenatally detected bilateral ureteropelvic junction obstruction. Methods: Patients with prenatally diagnosed bilateral ureteropelvic junction obstruction who underwent initial pyeloplasty (aged <12 months at initial pyeloplasty) were offered to participate in the study. Patients were recruited from January 2012 to December 2015. The anteroposterior renal pelvic diameter, parenchymal thickness, and calyceal dilatation were evaluated. Predictive factors of contralateral pyeloplasty after initial unilateral pyeloplasty were also examined. Results: In total, 82 patients were included in the study (mean age, 2.8 months). Among all patients who underwent initial pyeloplasty, additional contralateral pyeloplasty was required in 11 patients (13.4%). The outcome of contralateral hydronephrosis was assessed as resolution, persistence, or surgery. The median anteroposterior renal pelvic diameter and calyceal dilatation were significantly different among the groups (p < 0.001). Calyceal dilatation of ≥10 mm and a calyceal dilatation/parenchymal thickness ratio of ≥5 strongly suggested the likelihood of a contralateral operation. Conclusions: In most patients with bilateral ureteropelvic junction obstruction, improvement or resolution of contralateral hydronephrosis following initial unilateral pyeloplasty can be expected. Patients with contralateral calyceal dilatation >10 mm and the calyceal dilatation/parenchymal thickness ratio >5 are at higher risk of surgery.