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[Hydronephrosis in children]
Insights
This study on pediatric hydronephrosis found that surgical outcomes depend on the degree of renal functional loss. Early intervention and appropriate surgical techniques are crucial for better results in children.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Pathology
Context:
- Hydronephrosis affects children aged 4-15, diagnosed via ultrasound, X-ray, and electromyography.
- Postoperative follow-up for 91 patients over 1-5 years provided data on ureteropelvic segment changes.
- Histological findings revealed three types of changes necessitating specific surgical approaches.
Purpose:
- To evaluate surgical outcomes in pediatric hydronephrosis based on renal function.
- To identify factors influencing surgical success and failure.
- To correlate histological findings with surgical technique selection.
Summary:
- 125 children with hydronephrosis underwent diagnosis and surgical follow-up.
- Surgical success rates varied with renal functional loss: 91.1% for up to 25% loss, decreasing to 61.5% for 75-100% loss.
- Graft plastic surgery contraindications include small segments, strictures, accessory vessels, and thin walls, impacting Andersen-Hynes operation choices.
Impact:
- Highlights the critical role of pre-existing renal function in predicting surgical success for pediatric hydronephrosis.
- Informs surgical decision-making, emphasizing the need for tailored approaches based on individual patient factors and disease severity.
- Underscores the importance of histological evaluation for guiding surgical strategy and improving patient outcomes.
Abstract:
The authors followed up 125 children with hydronephrosis aged 4-15. The diagnosis was based on ultrasound, radiological, x-ray, pelvic electromyography. Vitaiker's test findings. Postoperative follow-up covered 91 patients and lasted 1-5 years. Histological evidence provided data on 3 types of changes in the ureteropelvic segment. This necessitates not only Andersen-Hynes operation, but also graft plastic surgery contraindicated in the small-size segment, in extended stricture of the small-diameter segment, in existence of an accessory vessel, in the segment thin wall. Poor surgical outcomes were often the result of renal functional failure. In patients with renal functional loss up to 25% positive results were achieved in 91.1% of the cases, in the loss 26-50% in 81.8% of the patients, in the loss 51-75% in 79%, in that 75-100% in 61.5% of those surgically treated.