TY - JOUR
T1 - The risk factors and clinical significance of acute postoperative complications after unstented pediatric pyeloplasty
T2 - A single surgeon's experience
AU - Lee, Yong Seung
AU - Lee, Cho Nyeong
AU - Kim, Myung Up
AU - Jang, Won Sik
AU - Lee, Hyeyoung
AU - Im, Young Jae
AU - Han, Sang Won
PY - 2014/7
Y1 - 2014/7
N2 - Purpose To analyze the risk factors and clinical significance of postoperative complications after unstented pediatric pyeloplasty. Materials and Methods We analyzed 285 kidney units (KUs) on which unstented pyeloplasty was performed between April 2002 and March 2010. Measures included preoperative factors, postoperative complications, change in postoperative differential renal function (DRF), and failure of pyeloplasty. Risk factors for acute complications requiring additional ureteral stenting and decreased DRF were analyzed. Results During a median follow-up period of 67.0 months, an additional ureteral stenting was required in 28 KUs (9.8%) due to the development of acute postoperative complications after unstented pyeloplasty. The incidence of complications increased significantly as preoperative DRF increased. DRF of more than 60% was the only independent risk factor for acute complications. Postoperative decrease in DRF was observed in 58 KUs (22.4%) among 259 KUs analyzed. Pyeloplasty failure was observed in 10 KUs (3.5%). The development of acute complications was not a risk factor for a decrease in DRF or pyeloplasty failure. Conclusions Urinary diversion during pyeloplasty is not related to a decrease in DRF or pyeloplasty failure. However, in patients with a preoperative DRF of greater than 60%, diversion could be considered due to the high prevalence of complications.
AB - Purpose To analyze the risk factors and clinical significance of postoperative complications after unstented pediatric pyeloplasty. Materials and Methods We analyzed 285 kidney units (KUs) on which unstented pyeloplasty was performed between April 2002 and March 2010. Measures included preoperative factors, postoperative complications, change in postoperative differential renal function (DRF), and failure of pyeloplasty. Risk factors for acute complications requiring additional ureteral stenting and decreased DRF were analyzed. Results During a median follow-up period of 67.0 months, an additional ureteral stenting was required in 28 KUs (9.8%) due to the development of acute postoperative complications after unstented pyeloplasty. The incidence of complications increased significantly as preoperative DRF increased. DRF of more than 60% was the only independent risk factor for acute complications. Postoperative decrease in DRF was observed in 58 KUs (22.4%) among 259 KUs analyzed. Pyeloplasty failure was observed in 10 KUs (3.5%). The development of acute complications was not a risk factor for a decrease in DRF or pyeloplasty failure. Conclusions Urinary diversion during pyeloplasty is not related to a decrease in DRF or pyeloplasty failure. However, in patients with a preoperative DRF of greater than 60%, diversion could be considered due to the high prevalence of complications.
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U2 - 10.1016/j.jpedsurg.2013.11.003
DO - 10.1016/j.jpedsurg.2013.11.003
M3 - Article
C2 - 24952810
AN - SCOPUS:84902971025
VL - 49
SP - 1166
EP - 1170
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 7
ER -