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Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
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Factors associated with age at pyeloplasty in children with ureteropelvic junction obstruction

Vijaya M Vemulakonda1, Duncan T Wilcox, Timothy M Crombleholme

  • 1Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Ave, Campus Box B-463, Aurora, CO, USA, vijaya.vemulakonda@childrenscolorado.org.

Pediatric Surgery International
|July 6, 2015
PubMed

Insights

Early pyeloplasty for UPJ obstruction in children is linked to patient and hospital factors. However, this early intervention increases the risk of hospital readmission within one year.

Area of Science:

  • Pediatric Urology
  • Health Services Research

Background:

  • Ureteropelvic junction (UPJ) obstruction is a common cause of congenital hydronephrosis in children.
  • Pyeloplasty is the gold standard surgical treatment for UPJ obstruction.
  • Factors influencing the timing of pyeloplasty and its impact on outcomes require further investigation.

Purpose of the Study:

  • To identify factors associated with performing pyeloplasty in children younger than one year.
  • To determine if early pyeloplasty (before age one) increases the risk of hospital readmission.

Main Methods:

  • Retrospective review of 4499 children (0-18 years) who underwent pyeloplasty for UPJ obstruction from 1999-2009.
  • Utilized the Pediatric Health Information System (PHIS) database.
  • Analyzed patient demographics, insurance, illness severity, and hospital characteristics using logistic regression and Cox proportional hazards models.

Main Results:

  • Minority race, male gender, public insurance, high severity of illness, Southern region, and low hospital volume predicted early surgery.
  • Early surgery was significantly associated with an increased risk of hospital readmission within one year (Hazard Ratio 2.42).

Conclusions:

  • Patient demographic and hospital factors influence the timing of pyeloplasty in children with UPJ obstruction.
  • Early surgical intervention for UPJ obstruction is associated with higher readmission rates, highlighting potential outcome disparities.
Abstract

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