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Pelvi-ureteric junction obstruction in children

J R Macfarlane, D G Young

    Zeitschrift Fur Kinderchirurgie : Organ Der Deutschen, Der Schweizerischen Und Der Osterreichischen Gesellschaft Fur Kinderchirurgie = Surgery in Infancy and Childhood
    |May 1, 1981
    PubMed
    Summary

    This study reviewed 100 children with hydronephrosis due to pelvi-ureteric obstruction. Pyeloplasty yielded satisfactory long-term results, highlighting the infant kidney

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    Area of Science:

    • Pediatric Urology
    • Nephrology
    • Surgical Pediatrics

    Background:

    • Pelvi-ureteric junction obstruction is a common cause of congenital hydronephrosis in children.
    • Early diagnosis and intervention are crucial for preserving renal function.
    • Surgical management aims to restore urine flow and prevent further kidney damage.

    Purpose of the Study:

    • To review outcomes of surgical management for pelvi-ureteric junction obstruction in pediatric patients.
    • To evaluate the efficacy of different surgical techniques, including pyeloplasty.
    • To assess the long-term clinical, radiological, and renographic results following surgical correction.

    Main Methods:

    • Retrospective review of 100 pediatric patients with hydronephrosis secondary to pelvi-ureteric obstruction over 13 years.
    • Analysis of symptomatology, pre-operative investigations, and post-operative assessments.
    • Evaluation of surgical techniques, including dismembered pyeloplasty, nephrostomy, splintage, and vessel hitching for aberrant vessels.

    Main Results:

    • Overall satisfactory long-term outcomes were achieved following pyeloplasty, assessed clinically, radiologically, and renographically.
    • Dismembered pyeloplasty was the favored technique, with variations based on abnormality severity.
    • Simple vessel hitching provided good results in 12 patients with aberrant lower pole vessels.

    Conclusions:

    • Pyeloplasty is an effective treatment for pediatric hydronephrosis secondary to pelvi-ureteric obstruction, with excellent long-term results.
    • The infant kidney demonstrates significant recuperative potential, supporting a conservative surgical approach.
    • Surgical technique should be tailored to the specific nature and severity of the obstruction.

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