Comparison of Surgical Outcomes between Dismembered Pyeloplasty with or without Ureteral Stenting in Children with Ureteropelvic Junction Obstruction
김준, 박성찬, 황현호, 김종원, 전상현, 박성훈, 김건석,
소속 상세정보
김준 ( Kim June )
University of Ulsan College of Medicine Department of Urology
박성찬 ( Park Sung-Chan )
University of Ulsan College of Medicine Department of Urology
황현호 ( Hwang Hyun-Ho )
Joeun-Hyundai Hospital Department of Urology
김종원 ( Kim Jong-Won )
University of Ulsan College of Medicine Department of Urology
전상현 ( Cheon Sang-Hyeon )
University of Ulsan College of Medicine Department of Urology
박성훈 ( Park Seong-Hun )
Pusan National University School of Mechanical Engineering
김건석 ( Kim Kun-Suk )
University of Ulsan College of Medicine Department of Urology
KMID : 0358320120530080564
Abstract
Purpose: To evaluate the impact of temporary internal ureteral stents on the surgical outcomes of dismembered pyeloplasty in children.
Materials and Methods: The medical records of 70 children (76 renal units) who underwent dismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction at at Asan Medical Center between January 2005 and December 2010 were retrospectively reviewed. We classified the renal units into the stented group (22 renal units) and the nonstented group (54 renal units). Fifty-four of 70 patients were male and their mean age was 2.2±3.8 years old. The mean follow-up period was 29.6±16.8 months.
Results: Sixty-four children had unilateral UPJ obstruction. The mean stent duration was 31.9 days. As shown by evaluation of radiologic images, there were no significant differences between the stented group and the nonstented group during the follow-up period (p>0.05). The mean preoperative and postoperative anteroposterior pelvic diameters (APPDs) of the nonstented group were 31.3 mm and 15.1 mm, respectively (p<0.001). The preoperative and postoperative grades of hydronephrosis were 3.9 and 2.9, respectively (p=0.037). The mean preoperative and postoperative APPDs of the stented group were 36.4 mm and 15.6 mm, respectively (p<0.001). The preoperative and postoperative grades of hydronephrosis were 4 and 3.1, respectively (p<0.001). Repeat obstruction was shown in 4 subjects as a postoperative complication (5.7%). Two children from each group had recurrent UPJ obstruction, with percentages of 3.7% and 9%, respectively (p=0.575).
Conclusions: In a comparison of nonstented and stented groups during pediatric dismembered pyeloplasty for UPJ obstruction, no significant differences were found in the resolution of hydronephrosis or overall postoperative complications.
키워드
Child; Hydronephrosis; Stents; Ureteral obstruction
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