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[Is there a difference in the postoperative follow up of ureteropelvic junction obstruction according to age?]
Y González Ruiz1, P Bragagnini Rodríguez1, A Siles Hinojosa1
1Servicio Cirugía Pediátrica. Hospital Infantil Miguel Servet. Zaragoza.
Insights
Younger children (<1 year) with ureteropelvic junction obstruction (UJO) show greater reduction in renal anteroposterior diameter post-surgery. Renal function improved in both age groups after pyeloplasty.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Renal Physiology
Background:
- Ureteropelvic junction obstruction (UJO) is a common cause of congenital hydronephrosis in children.
- Surgical intervention, typically pyeloplasty, is the standard treatment for symptomatic UJO.
- Age at intervention may influence postoperative outcomes and renal recovery.
Purpose of the Study:
- To compare the postoperative follow-up of pediatric patients undergoing surgical treatment for UJO.
- To evaluate differences in outcomes between patients younger than 12 months and those older than 12 months at the time of surgery.
Main Methods:
- Retrospective study of 77 patients (78 kidney units) treated for UJO between 2007 and 2014.
- Patients were divided into two groups: Group A (≤ 12 months) and Group B (> 12 months).
- Analysis included epidemiological, clinical, echographic, and renogram variables, alongside outcomes and complications. Statistical significance was set at p < 0.05.
Main Results:
- No statistically significant differences were found in preoperative or postoperative renal function between Group A and Group B.
- Complication rates were similar between the two groups (p = 0.429).
- A statistically significant reduction in renal anteroposterior diameter (DAP) was observed at 3 months postoperatively in Group A compared to Group B (p = 0.047).
Conclusions:
- Pediatric patients younger than 1 year with UJO experience a greater reduction in renal DAP postoperatively.
- While renal function shows improvement after pyeloplasty in both age groups, this improvement is not statistically significant.
- Age is a factor influencing specific postoperative parameters like renal DAP reduction in UJO management.
Objective:
To compare postoperative follow up in patients older and younger than 12 months who underwent surgical treatment of ureteropelvic junction obstruction (UJO).
Material And Methods:
Retrospective study of 77 patients, 78 kidney units, intervened from UJO (2007-2014). We analyzed epidemiological, clinical, echographic, and pre and postoperative renogram variables, outcomes and complications. We divided the patients into 2 groups according to age: group A ≤ 12 months and group B > 12 months, comparing the results by statistical analysis, considering p < 0.05 statistically significant.
Results:
Group A: 38 patients, 26 males (68.4%), one bilateral UJO and 22 rights (57.9%), 36 prenatal diagnoses (92.3%) and mean age of intervention 5.28 months [range 0.24 -11,28]. We performed 9 minilumbotomies, 29 assisted by retroperitoneoscopy (ARP) and 1 pneumatic dilation (PD). Group B: 39 patients, 26 males (66.7%), 10 rights (25.64%), 19 prenatal diagnoses (48.7%) and mean age 6.13 years [range 1.13-14.52]. 15 minilumbotomies, 20 ARP, 3 laparoscopic and 1 PD. Preoperative mean renal function (MRF) of group A: 35.9 ± 13.4 [range 8-57] vs. 39.74 ± 13.91 [range 9-57] in group B (p = 0.347). Postoperative MRF 43.29 ± 18.2 [range 12-100] group A and 39.41 ± 12.89 [range 11-54] group B (p = 0.464). Group A and B: 11 and 8 complications, respectively (p = 0.429). We did not find statistically significant differences in the mean preoperative anteroposterior diameter (DAP) between both groups (p = 0.313). We compared DAP at 3, 6, 12, 24 and 48 postoperative months, observing a greater reduction of DAP from group A compared to B; however, we found only statistically significant differences in DAP at 3 months postoperatively (p = 0.047).
Conclusion:
Renal DAP is reduced postoperatively more in patients younger than 1 year. Moreover, an improvement of the DRF after pieloplasty can be observed despite not being statistically significant.
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